This week's case is a stool specimen from a 52-year-old Bolivian farmer. He complains of intermittent right upper quadrant pain, and an abdominal CT showed edema and dilation of the bile ducts.
I always tell my students and technologists that size matters in parasitology. While Fasciola comes to mind for this clinical presentation and ova appearance, can you r/o fish tapeworm -- whatever the genus name is this week -- without measuring these?
Given the geographic location, I would agree with an identification of Fasciola hepatica also with an abopercular area where the shell appears thickened or rough. I also consider Sheldon’s opinion regarding the size of the eggs in question. In endemic countries of South East Asia, the exact identification is particularly difficult where there is a mix not only of Fasciola hepatica and Fasciola gigantica as well as Fasciolopsis buski. Florida Fan
Agree with Fasciola hepatica. Given the geographic distribution, it´s less likely to be Fasciolopsis buski; Fasciola gigantica or Echinostoma ilocanum.
Fasciola Egg
ReplyDeleteFasciola hepatica eggs ... The Northern Altiplano of the Department of La Paz, Bolivia is one of the most endemic areas of Fascioliasis in the world
ReplyDeleteI always tell my students and technologists that size matters in parasitology. While Fasciola comes to mind for this clinical presentation and ova appearance, can you r/o fish tapeworm -- whatever the genus name is this week -- without measuring these?
ReplyDeleteThank you
DeleteFasciola sp.
ReplyDeleteGiven the geographic location, I would agree with an identification of Fasciola hepatica also with an abopercular area where the shell appears thickened or rough. I also consider Sheldon’s opinion regarding the size of the eggs in question. In endemic countries of South East Asia, the exact identification is particularly difficult where there is a mix not only of Fasciola hepatica and Fasciola gigantica as well as Fasciolopsis buski.
ReplyDeleteFlorida Fan
Fasciola sp
ReplyDeleteFasciola hepatica.
ReplyDeleteFasciola hepatica considering geography, site of illness and egg morphology: large and operculated
ReplyDeleteAgree with Fasciola hepatica. Given the geographic distribution, it´s less likely to be Fasciolopsis buski; Fasciola gigantica or Echinostoma ilocanum.
ReplyDelete