Happy American Independence day (July 4th) and a belated Canada day (July 1st)! As an American, this weeks case very appropriately has a lot of red, white, and (purple-ish)
blue. The following round objects were seen in a stool specimen on modified acid fast. The patient has had more than 1 week of profuse watery diarrhea and abdominal discomfort.
These objects were also highlighted with using calcofluor white fluorescence staining (arrow) along with stool flora.
What are these objects? Are they fungus or parasite?
Favor cryptosporidium spp. based on size, and staining characteristics.
ReplyDeleteCryptosporidium parvum? It is a parasite.
ReplyDeleteJudging by the size and staining characteristics I would favor Cryptosporidium oocyst as well.
ReplyDeleteFlorida Fan
The size and appearance (in addition to the patient's symptoms) make me think of cryptosporidium parvum. It's a parasite.
ReplyDeleteVery intriguing case indeed! Actually on second thought, I remember that fungal ascospores like those of Saccharomyces cerevisiae stain acid fast with Kinyoun stain and fungi do fluoresce when stained with Calcofluor under UV excitation. Coccidian oocysts auto fluoresce, they don’t need to bind non specifically with Calcofluor. Saccharomyces cerevisiae is part of the intestinal normal flora even in the rare cases of people getting drunk after a big pasta meal. Let’s see how Dr. Pritt is going to solve the enigma.
ReplyDeleteFlorida Fan
In view of staining properties, size and clinical image, I would also favor Cryptosporidium sp.
ReplyDeleteCryptosporidium is a parasite.
Although it is often abbreviated as "Crypto", it should not be confused with Cryptococcus (which is a fungus).