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.
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The Fine Print: Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
10 comments:
Fasciola Egg
Fasciola hepatica eggs ... The Northern Altiplano of the Department of La Paz, Bolivia is one of the most endemic areas of Fascioliasis in the world
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?
Fasciola sp.
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
Fasciola sp
Thank you
Fasciola hepatica.
Fasciola hepatica considering geography, site of illness and egg morphology: large and operculated
Agree with Fasciola hepatica. Given the geographic distribution, it´s less likely to be Fasciolopsis buski; Fasciola gigantica or Echinostoma ilocanum.
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