Case of the Week 787

 This week's case is from Dr. Beth Adams who encountered a patient in the Moskitia region of Honduras who had coughed up the following object. What is your presumptive identification?

Case of the Week 786

 This week's case was generously donated by Dr. Richard Bradbury from James Cook University in Australia. The following object was seen in the stool from a patient with advanced HIV infection living in Tanzania. Shown are preparations using differential interference contrast (DIC), darkfield, and fluorescent microscopy (wavelengths unknown). The objects measure approximately 25-30 micrometers in length. What is your identification?

Answer to Case 786

 Answer to the Parasite Case of the Week 786: Cystoisospora belli

Idzi nicely described this finding as an "Immature oocyst of Cystoisospora belli (formerly known as Isospora belli) containing only one sporoblast, which will evolve to two sporoblasts and later on will sporulate to become infective." 

While we don't know the definitive details of the images that Dr. Bradbury provided, Idzi suggested that "the last one could be autofluorescence at 450-490 nm." and noted that "All coccidia (including Cystoisospora belli) will demonstrate fluorescence (without prior staining) when placed under UV-light. They will show up as bright blue structures when using an excitation filter of 330-365 nm, or green at 450-490 nm. Of note: Cryptosporidium is not placed among the coccidians anymore (moved to the Gregarines), and does not demonstrate autofluorescence either!"

If you are interested about how autofluorescence can be used for diagnosis, you should check out Blaine's and Dr. Marc Couturier's recent paper "Shedding new light on Cyclospora: how the use of ultraviolet fluorescence microscopy can improve diagnosis of cyclosporiasis".

Case of the Week 785

It's the first of the month and time for a case from Idzi Potters and the Institute of Tropical Medicine, Antwerp! 

The following images show an object that dropped out of a patient's nose 😮. What is your identification?

Wishing all of my American readers a very happy and restful Labor Day.