This week's case is a very sad situation in which a highly immunocompromised patient died from her parasitic infection (in addition to multiple other co-infections). The following is a whole slide scanned section from her small intestine that was obtained at autopsy.
Here are some screen shots as well:
What is your identification?
Bonus questions:
- Are there any infectious concerns with with handling the fresh autopsy specimens?
- What parasite forms are seen in this specimen?
4 comments:
The morphology of the egg with its thin, smooth shell and the presence of several larvae are compatible with Strongyloides stercoralis infection. In the upper left side of the slide, the larvae has a lateral depression compatible with the genital primordium, also a rough estimate of the size seems to agree with a rhabditiform larvae. As always when dealing with Strongyloides stercoralis, all precautions should be taken to avoid a percutaneous infection with filariform larvae possibly present in the raw specimen.
Florida Fan
Where is the egg?
I almost completely agree with Florida fan!
I see numerous thin-shelled eggs (sometimes containing larvae already) and (rhabditiform) larvae that seem to be compatible with Strongyloides stercoralis. But the structure in the upper left part of the slide seems too big to be a larva. I suspect it to be an adult female (no parasitic males in Strongyloides!).
As Florida fan indicated: yes, handle with care (and the necessary precautions) as there is a risk of transcutaneous infection by filariform larvae possibly present in the sample.
As an answer to Anonymous: if you look at the second picture that Dr. Pritt provided, the eggs are the oval shapes in the left half of the image, while the curved structure in the right half of that same image is one of the larvae.
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