This week's fun case was donated by Dr. Chris Hartley. The following object was seen on from material obtained by endobronchial, ultrasound-guided biopsy (Giemsa-based stain). How would you sign this case out?
Giemsa stain and Giemsa based stains are prepared by grinding and dissolution of the powder in methanol, often in the open air or at best in a chemical fumes hood. This type of hood draws in ambient air as well as chemical fumes and exhaust the mix out of the building, thus protecting the operator. The incidentally found fly could have been the victim of the draft created by the fumes hood (sucked in) and overcome by methanol fumes it simply crashed landed into the being prepared reagent. My more tragic scenario is like this: Once there was an illiterate alcoholic fly, it couldn’t read the warnings on the bottle label nor resisted its inclination. Awakened by the irresistible olfactory capacities, the valiant airborne made a kamikaze dive into its lethal beverage. Sadly, besides this fly we might wonder how many more have been victims of the illicit cheap wood alcohol. This finding is most likely incidental or just an incidental contamination of the sample. Florida Fan
I believe this to be a Springtail with its furcula (a primary diagnostic feature) conveniently tucked beneath its abdomen. A non parasitic incidental find. Springtails are small and sometimes occur in large groups. it's possible this one could have been inhaled from environment.
I am in favor of an accidental inhalation of this non-flying animal. Some more information on the background (reason for the biopsy), the patient's age and recent outdoor activities (play, sports? agrarian?) could help to understand the circumstances of the incident.
incidental inhalation of a springtail (Collembola).
Interesting side-note, collembolans have been implicated in 'Morgellon's Syndrome' (a nice word for delusional parasitosis), because of objects resembling collembolans seen in skin scrapings. Collembolans are ubiquitous in soil and may enter houses; the chances of them contaminating clinical specimens (esp people with D.P. that usually don't live in the most hygienic conditions) is not farfetched!
...I should have said incidental inhalation or possibly contamination of a stain/buffer. There really is nothing in this image wholly supporting its presence in the clinical specimen.
A number of collembola species are semi aquatic, living on the surface of water which possibly could find it's way into a swimmer through nose or mouth.
Bug ie. insect, probable contaminant, maybe arising from endobronchial biopsy tube. I do not see much background inflammation. BW from Vt
ReplyDeleteGiemsa stain and Giemsa based stains are prepared by grinding and dissolution of the powder in methanol, often in the open air or at best in a chemical fumes hood. This type of hood draws in ambient air as well as chemical fumes and exhaust the mix out of the building, thus protecting the operator. The incidentally found fly could have been the victim of the draft created by the fumes hood (sucked in) and overcome by methanol fumes it simply crashed landed into the being prepared reagent.
ReplyDeleteMy more tragic scenario is like this: Once there was an illiterate alcoholic fly, it couldn’t read the warnings on the bottle label nor resisted its inclination. Awakened by the irresistible olfactory capacities, the valiant airborne made a kamikaze dive into its lethal beverage.
Sadly, besides this fly we might wonder how many more have been victims of the illicit cheap wood alcohol.
This finding is most likely incidental or just an incidental contamination of the sample.
Florida Fan
I believe this to be a Springtail with its furcula (a primary diagnostic feature) conveniently tucked beneath its abdomen. A non parasitic incidental find. Springtails are small and sometimes occur in large groups. it's possible this one could have been inhaled from environment.
ReplyDeleteI am in favor of an accidental inhalation of this non-flying animal. Some more information on the background (reason for the biopsy), the patient's age and recent outdoor activities (play, sports? agrarian?) could help to understand the circumstances of the incident.
ReplyDeleteincidental inhalation of a springtail (Collembola).
ReplyDeleteInteresting side-note, collembolans have been implicated in 'Morgellon's Syndrome' (a nice word for delusional parasitosis), because of objects resembling collembolans seen in skin scrapings. Collembolans are ubiquitous in soil and may enter houses; the chances of them contaminating clinical specimens (esp people with D.P. that usually don't live in the most hygienic conditions) is not farfetched!
...I should have said incidental inhalation or possibly contamination of a stain/buffer. There really is nothing in this image wholly supporting its presence in the clinical specimen.
ReplyDeleteA number of collembola species are semi aquatic, living on the surface of water which possibly could find it's way into a swimmer through nose or mouth.
ReplyDeleteCollembola, possibly Psocoptera
ReplyDeleteProbably incidental