This week's case was generously donated by Dr. Ben Von Bredow. The following object was sent to the laboratory for identification after being passed by a patient from Michigan. No additional information is available. What is your identification?
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10 comments:
T solium?
Wow, that’s pretty rare to have the filamentous anterior portion where the name diphyllobothrid derives from. The posterior portion is composed entirely of craspedote proglottids with a central line of genital organs. The patient must have some unsanitary raw fish. Either the Sashimi or Sushi dish was the source of the infection. A historic wood print in a medical school in Japan shows the extraction of Dibothriocephalus latus. The print has been published in an issue of EID many years ago and grossed out the majority of my coworkers, to me it is a historic medical evidence.
Florida Fan
Dibothriocephalus latus (formerly Diphyllobothrium latum commonly called zipper worm because of the black uterine pore in the centre like a zipper. Also called broad fish tapeworm.
This appears to be Dibothriocephalus latus fish tapeworm (Cestode) with the broad proglottids with the “shoulders” side profile. This is associated with the ingestion of undercooked or raw infected freshwater fish.
Dibotriocephalus species. /Patrik
Wow! You can see the scolex in the narrow part. Wish you share those photos too.
I agree with everyone on the identification, since it's probably from freshwater fish (had to look where Michigan is). Here in my country we have to inform these findings like: "Dibothriocephalus sp / Adenocephalus sp (ex Diphyllobothrium sp)", we never know if the patient consumed saltwater o freshwater fish, but I've seen more cases from eating ceviche than sushi/sashimi. Another great source of infections is smoked salmon, specially from the south part of my country.
-HLCM fan.
Hi Florida Fan and HLCM fan, I wish I could say that we have the scolex to show the classic leaf shape with 2 bothria. Unfortunately, on higher power, it was just very narrow proglottids. Perhaps we got the neck region, right below the scolex. I've also never seen a scolex in a real clinical specimen!
Dr. Pritt: I only saw the drawing of this tapeworm in the text books. Even after fifty two years working in clinical microbiology, I still only got the tail end. It was only a wishful thought.
Florida Fan
Could this alternatively be a Spirometra sp.?
Diphyllobothrium latum
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