Happy Autumn, everyone! It's the first Monday of the month and time for our monthly case from Idzi Potters and the Institute of Tropical Medicine, Antwerp. The following were seen in a direct wet mount specimen of stool from a patient with chronic constipation. What is your identification?
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6 comments:
Cases from Idzi are never “a piece of cake” nor sweet like “chocolat belge”. The good thing is that they always make us use our gray matter. From the video, the movement lacks the “falling leaves” of Giardia, rather it resembles more to that of Trichomonas vaginalis. Being a stool concentrate, my HO is Pentatrichomonas hominis and saying this I just “take my leap of faith “.
Florida Fan
Giardia intestinalis trophozoites?/Patrik
I agree with Florida Fan, the movement resembles more that of a Trichomonas. Alas, I never seen trophozoites of Chilomastix in wet mount, so I can't be 100% sure.
-HLCM fan
https://youtu.be/b7Z5mrgtojg
HLCM fan, here’s a link to a video of Chilomastix mesnili. Hope it helps.
Florida Fan
Florida fan:
Thanks! From the video I can tell they are diferent, so I'll stick with Pentatrichomonas.
-HLCM fan
Thank you for the very "seasonal" case...very romantic !
The “falling leaf” movement immediately makes me think of Giardia duodenalis, as patients can be chronic asymptomatic carriers. I’m not sure if other flagellated “cousins” show the same movement… but Chilomastix mesnili or Enteromonas hominis would be part of my differential diagnosis. Cysts, if present, would be very welcome!
Thanks for sharing — awesome video!
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