This week's case was donated by Dr. Sandeep T. You may remember the amazing case of fasciolopiasis he provided back in 2012 (and if not, you should definitely check it out HERE). His latest case is from a middle aged taxi driver who reports passing white objects in is his stool for the past 2 years. He denies fever, weight loss, vomiting and diarrhea. A routine complete count is unremarkable with no anemia. Below is one of the white objects submitted for pathologic examination. Identification? What additional procedures would be helpful in this case?
4 comments:
I remember having the proglotids of the tape worm crawling down my thighs when I was a boy. The protruding vagina on the upper side point to a Toenia sp. The striated outer shell of the tape worm ascertain its genus. Just from the photographs we cannot identify the tape worm to be one from beef or pork or an Asian tape worm.
Florida Fan
This is definitely a Taenia species and I would suspect T saginata. However, you need to inject it with ink and count the number of uterine branches to be sure it is not T solium. Even then, the proglottids of T saginata and T asiatica are morphologically identical.
Oops, my mistake. Toenia solium scolex has a rostrum surrounded by a crown of hooklets. Toenia saginata has no rostrum nor hooklets. India ink injection of the proglotids helps in the differentiation, T. saginata has on one side more than twelve primary uterine branches but T. solium has less than twelve primary branches. A ribosomal analysis will differentiate between T. saginata and it’s Asian counterpart.
Florida Fan
1. Check the history to see if something has crawled out through the anus on their own 2. Check eating habits and ethnicity 3. Press harder to observe the branch 4. Multiplex PCR 5. Recommend requesting a free diagnosis to iPRB (admin@parasiteworldbank.org).
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