This week's case was generously donated by Drs. Cameron Truarn and Damien Bradford from PathWest Laboratory Medicine, and Drs. Huan Zhao and Richard Bradbury from James Cook University, Australia.
The following objects were noted in a bronchoalveolar lavage from a middle-aged immigrant from Asia, now living in Australia. They measure approximately 1000 micrometers long. What is seen here? Please be as specific as possible.
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9 comments:
Larva of Strongyloides
Strongyloides stercoralis filariform larvae. Since this is from BAL (and you wouldn't expect younger larvae in BAL), the tail is pointy and thin, and they are pretty big.
I would agree with ebrahim on the identification though the tail in the third picture appears notched. The geographic location of the patient does agree with the diagnosis.
And probably bacteria in the background as part of a strongyloides hyperinfection so probably a very sick patient with a poor prognosis and some further background clinical history of steroids etc.
I agree with previous comments: Strongyloides stercoralis autoinfective larvae. The presence of a relatively large genital primordium confirms Strongyloides. The apparently tapered tail (not notched) together with the size of the larva point towards the fourth-stage autoinfective larva (L4).
Strongyloides stercolaris filariform/Patrik
Beautiful pictures! The larva has a short buccal cavity, which differentiates Strongyloides from hookworms.
The size (1000 um) is throwing me. Too large for Ascaris, hookworm or even Strongyloides larvae. This might be more consistent with an adult Strongyloides?
Could be Strongyloides stercoralis filariform larvae.
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