Monday, January 4, 2021

Case of the Week 621

Happy New Year everyone! We are going to kick off the New Year with a fascinating (and challenging) case by Idzi Potters and the Institute of Tropical Medicine, Antwerp

From Idzi: While I was rummaging through the education-samples, I stumbled upon a strange-looking, small vial, containing a liquid from unknown origin. When I looked at the identification label, I was quite surprised to find a name that sounded like a very exotic parasite…

During a quick microscopical examination, I found eggs of about 60-70 ┬Ám in length.


Who can guess which parasite I found? Hint: the source ended up being a cyst near the ear from an African man.

19 comments:

Anonymous said...

Idzi, very tricky case indeed. The operculated ova with an obopercula protrusion as well as the size, all consistent with Diphyllothriids ova.
My African parasitology knowledge is fairly limited, be free to educate me on this unusual case.
Florida Fan

Old One said...

I agree with Florida Fan. The eggs are the size, and morphology Pseudophyllidean eggs particularly reminiscent of the eggs of Spirometra.

Here is my hypothesis: Amphibians are often the intermediate host of larval Spirometra (Spargana). Slit frogs are used as a compress for human wounds. This is one way larval Spirometra are passed from infected frogs to humans. Is it possible that the passed spagana matures to an anencysted, gravid adult in a human ???

Luis said...

Looks like spirometra eggs

Parasitjessica said...

Paragonimus? I think i have heard absolut a case of paragonimus or att least something similar presenting as a cyst near an ear...

Old One said...

Can I change my mind???

ParasiteGal said...

Old One, yes, you can change your mind as often as you'd like :)

I will say that, so far, no one has gotten the correct answer. I will provide a hint in a day or two after more people have had a chance to consider the case.

Stay tuned!
Bobbi

Anonymous said...

Looks like Clonorchis, but the neck cyst and the continent of origin don't match.

Bernardino Rocha said...

Is this a case of Achillurbainia spp. ?

Anonymous said...

Looks like Paragonymus egg but smaller. I suggest Poïkilorchis / Achillurbainia congolensis. There has been a case in the UK , a Nigerian man presented with a neck lump and otitis media and these Paragonimus-like eggs were found in the neck lump aspirate.

Old One said...

I've found the older I get, the more often I change my ever shrinking mind. I still have lots of fun with these unknowns.

Choe said...

Paragonimus like! Achillurbainia sp. :)

Anonymous said...

Bernardino Rocha,
I believed you shed a light. There are not that many articles on this trematode. There are a few sparse articles and no photographs. For sure the rule “a picture is worth a thousand words” has been omitted.
Florida Fan

Richard Bradbury said...

I think this is Achillurbaina congolensis - nice case!!

Old One said...

I believe I found a photo:

Journal of Infection
Volume 54, Issue 2, February 2007, Pages e103-e106

Otitis media and a neck lump – Current diagnostic challenges for Paragonimus-like trematode infections

H.SchusterbF.O.AgadaaA.R.AndersonaR.S.JacksonbD.BlairdH.McGanncG.Kellya

The authors appear to favor achillurbainiasis over extra pulmonary paragonimiasis

Sir Galahad said...

Diphyllobotrium latum...

Amy said...

Dear Old One,

I looked at the paper you've sent, and was wondering about the lack of button?

A New Trematode, Poikilorchis congolensis, n.g., n.sp., living in Subcutaneous Retroauricular
Cysts in Man from the Belgian Congo. Nature, 1957. Vol 179

This one also seems to lack to button. But maybe it's just not visible.

Bernardino Rocha said...

Some authors argue that Achillurbainia congolensis is a synonym of Poikilorchis congolensis, given the similarities.

Old One said...

A question for Idzi. Did this specimen come from Dr. Fain's Case study published in Nature,1957. Vol.179?

Thanks Amy, I'll leave the ID to others.

Idzi P. said...

@Old One: although I cannot be 100% sure, I think it is quite likely that this is indeed the original specimen!
I must say that I am very much impressed with the answers and comments coming in on the blog!
Way to go!
Parasitology RULES! ;-)
Happy 2021 to all of you!