Tuesday, March 9, 2021

Case of the Week 629

 This week's case is from my laboratory. The following structures were found in a concentrated stool specimen from a middle-aged man from Ethiopia. They measure approximately 65 micrometers in length. What is the most-likely identification?


Eagleville said...

Hookworm eggs

Unknown said...

Ancylostoma duodenale.
Necator America is.

Crespoo said...

hookwarm egg

Sam said...

Finally! An end to the "is this hookworm?" trilogy. Haha 😁

So yeh, I would say hookworm ova. Can't differentiate between species based on microscopy of ova, but either Necator americanus or Ancylostoma duodenale.

I'm also pretty certain in image two those long sharp objects are Charcot-Leyden crystals. The breakdown products of eosinophils. Makes sense, with eosinophilia being another laboratory finding (within a full blood count in Haematology) in some parasitic infections.

Anonymous said...

Finally a case we can see in the lab with clinical significance. No more “trompe l’œil’’ that torment the brain. Just like the Strongyloides stercorales, hookworm filariform larvae penetrate through the exposed skin and in tropical areas where people walk barefoot together with the use of night soil for agriculture, hookworm infection is fairly common.
Florida Fan

TheOracle said...

Marvelous hookworm ova. The genre diagnosis between Ancylostoma and Necator can be made by studying the morphology of the larvae's adherence structures.

In the second image I think we can also observe Charcot-Leyden's crystals, made of galectin-10 produced by eosinophils in response to allergies or parasitic infestations.

Italian new fan!

Idzi P. said...

Indeed, hooray for "real" parasites ;-)
These should be reported as "hookworm ova".
If you would ask for the "most-likely" identification, I'd dare guessing "Ancylostoma duodenale" - not per sé due to the fact that the patient is from the African continent (as migration and travel have mixed A.duodenale and N. americanus geographically up), but the second picture shows an egg with a very low number of blastomeres (only 4!). This low level of cleavage in freshly produced feces is more typical for A. duodenale. Necator usually has "already" about 8 blastomeres in freshly passed feces.
That being said, I'd still report this as "hookworm ova"...

Sir Galahad said...

Hookworm eggs, forse Necator americanus perchè leggermente più grande ( 65 micron) di Ancylostoma duodenale