Monday, May 3, 2021

Case of the Week 637

Welcome back to the first Monday of the month! It's time for our monthly case from Idzi Potters and the Institute of Tropical Medicine in Antwerp. The following structures were found in a stool specimen from a patient originally from the Democratic Republic of the Congo. He presented with long standing diarrhea (occasionally bloody), intermittent abdominal pain, decreased appetite and unintentional weight loss. They are approximately 200 micrometers long.


What is the most likely identification?

13 comments:

Anonymous said...

Schistosoma haematobium egg with a the characteristic lateral spine and the miracidium inside.

Eagleville said...

S. intercalatum. Terminal spine (so not S. mansoni). S. intercalatum is found in DRC.

Anonymous said...

For sure this is a case of schistosomiasis. The fact is that the pictures show an equatorial bulge and they’re shed in the stool instead of the urine lead me to an identification of Schistosoma intercalatum. Thanks Idzi, we don’t get to see these very often.
Florida Fan

Chris Whipps said...

Well, at a quick glance I was about to say Schistosoma haematobium, BUT... this was from the stool, and on closer inspection the egg has a bulge in the middle, so I'm going with Schisosoma intercalatum (and I'm giving this one to my students next fall!)

Anonymous said...

Schistosoma fosho-ma!

Sam said...

The patient's specific travel history, large size of the ova, and the central bulge of the ova all point towards Schistosoma intercalatum. We can rule out S.haematobium as the ova in this case have been shed from faeces (as opposed to urine), and the size is significantly larger than S.haematobium. The patient also presented with gastrointestinal rather than urinary tract symptoms expected from S.haematobium (specifically, haematuria).

Ali Mokbel said...

Yep....me too.It's gonna be a nice challenge for med lab students.

Anonymous said...

Schistosoma intercalatum

nema said...

Schistosoma intercalatum

Sir Galahad said...

Schistosoma intercalatum, ova

Bernardino Rocha said...

Agree with Schistosoma intercalatum. We can rule out Schistosoma mattheei, given the size of the egg and clinical presentation.

Ai6an said...

I feel lost. Found this blog from a 2014 post. At what point did people become so knowledgeable? Or, does this just attract people with a very niche knowledge base? I think this is interesting, but the comments read like they have been following your posts for years and you've taught them to identify these things.

ParasiteGal said...

Hi Ai6an, I agree that the material is a bit advanced for the general public and beginning students. Although everyone is welcome at this blog, a better source of general information would be the CDC. The bulk of their material is written for the general public. They also provide links for more advanced information. Best of luck in your educational journey!