Case of the Week 759

 This week's case is very appropriate for Halloween! The following object was found attached to the wall of the terminal ileum during screening colonoscopy. It was removed and sent to the parasitology laboratory for identification where it was cleared and mounted on a glass slide. It is approximately 1-cm long. Images by Heather Morris.

What is your diagnosis? The answer will be posted on Halloween, courtesy of Dr. Jacob Rattin.

 

Answer to Case 759

 Answer to the Parasite Case of the Week 759: Female Ancylostoma duodenale

The following explanation is by the outstanding PGY-2 pathology resident, Dr. Jacob Rattin:

In humans, intestinal hookworm infection is predominantly caused by Ancylostoma duodenale, Necator americanus, and A. ceylanicum. Adult hookworms live in the small intestine (typically the distal jejunum) and use specially-adapted mouthparts to attach to the intestinal mucosa and feast upon the host’s blood (creepy!). Females release unembryonated eggs into the feces where they mature in the soil and then release larvae. These infectious larvae can pierce human skin and travel in the blood to the lungs where they can penetrate alveoli and make the ascent up the bronchial tree and into the pharynx. After being swallowed, they make their way to the small intestines where they attach. Chronic infection results in iron-deficiency anemia and malnutrition (dreadful!). Rarely, heavy infection can result in death, especially in infants.

The sizes and morphology of rhabditiform larvae, filariform larvae, and adults differ. For ease of comparison and reference, a table has been made for Ancylostoma duodenale.

Stage	Size	Morphology
Rhabditiform (L1) larvae	250-300 µm long	- Long buccal canal - Inconspicuous genital primordium - Can occasionally be seen in stool when there is a delay in processing (see COTW 757), and need to be distinguished from L1 Strongyloides stercoralis larvae.
Filariform (L3) larvae	500-700 µm long	- Ensheathed, pointed tail
Adults	Females: 10-15 mm long Males:  8-12 mm long	- Sharp teeth - the male tail has a large fan-like copulatory bursa, while the female has a pointed tail.

 

The buccal capsule shows the characteristic cutting teeth in this image of Ancylostoma duodenale, which differentiates it from Necator, which has cutting plates. The teeth of A. ceylanicum have a similar appearance to that of A. duodenale but have larger from teeth.

This scary appearance really shows how A. duodenale is like a real vampire!

For extra tricks and treats, check out my past parasite-themed Halloween images:

https://www.parasitewonders.com/parasites/fun-parasite-images

Case of the Week 566

Happy Halloween everyone! In honor of this week, I have photos from my annual Halloween party, and a special 'unknown' from Old One. Feel free to guess what my guests' costumes were:

Me and Felicity with (unplanned) matching costumes. Any ideas what we were?

Me and Old One (so great to meet him in person!)

Heather and her 'life cycle' family

Natalia, Zerelda and Pooja representing the exposure and treatment course for this common parasite:

Another take on this fun parasite by Emily and Nick:

Rebecca, Aimee and Emily demonstrating the woes of being a Clinical Microbiology fellow:

Casey and his wife as another classic parasite:

Kyle and his tapeworm family:

There were many more wonderful costumes that I didn't get pictures of (and many that weren't parasite-related that I will post separately on Facebook). 

And last but not least, HERE is Old One's contribution of a hand-drawn case, animated by his son.

Answer to Case 566

Answer: lots of fun parasite Halloween costumes; here are the 'answers'

   

Halloween Parasite #5

HERE is Halloween Parasite #5, the last in my series of creepy dreadful wonderful parasites for the Halloween season. These pieces are written for the general public, including children, and aim to interest more people in the fascinating world of parasitology.

Halloween Parasite #4

Happy Halloween Week everyone! As you all know, parasites can be creepy dreadful, but also fascinating, and sometimes even helpful. As a special Halloween treat, I'll be highlighting 5 different parasites on the Mayo Clinic News Network - 1 each day. HERE is parasite #4 - "worms in love" These are written as educational pieces for the general public. Feel free to use the text and images for your own educational purposes.

Halloween Parasite #3

Happy Halloween Week everyone! As you all know, parasites can be creepy dreadful, but also fascinating, and sometimes even helpful. As a special Halloween treat, I'll be highlighting 5 different parasites on the Mayo Clinic News Network - 1 each day. HERE is parasite #3 - . These are written as educational pieces for the general public. Feel free to use the text and images for your own educational purposes.

Halloween Case #2

Happy Halloween Week everyone! As you all know, parasites can be creepy dreadful, but also fascinating, and sometimes even helpful. As a special Halloween treat, I'll be highlighting 5 different parasites on the Mayo Clinic News Network - 1 each day. HERE is parasite #2 - scalp explorers. These are written as educational pieces for the general public. Feel free to use the text and images for your own educational purposes.

Halloween Case #1

Happy Halloween Week everyone! As you all know, parasites can be creepy dreadful, but also fascinating, and sometimes even helpful. As a special Halloween treat, I'll be highlighting 5 different parasites on the Mayo Clinic News Network HERE - 1 each day.

I unfortunately will not be having a Halloween party this year since I am at the annual meeting of the American Society of Tropical Medicine and Hygiene in New Orleans. Therefore I won't have any costume photos from my party, but I promise to post photos later if I see any particularly parasite-like costumes on Bourbon street!

Case of the Week 500!!!

Welcome to my 500th Parasite Case of the Week - a special celebration of our parasitology community.

I feel so fortunate to have such wonderful readers. You keep me on my toes, send me amazing cases, and teach me a lot. I had asked for submissions of your parasite-related artwork and received some amazing entries. I put the names of all contributors into a hat and randomly selected the following 3 names:
Sheldon Campbell
Piotr Kochan
Melanie Riblett

Congratulations! I will reach out to you later to give you your prizes :)

So now without further ado, here are all of the fabulous parasite creations of our talented group:

Kate Grannis - chalk art

Marc Courturier - baked goods

Blaine Mathison - Halloween cupcakes! AND pinworm eggs - a giant scotch tape prep:

 Andrea Dahl - multimedia ticks!

Melissa Blessing - Giant Microbe® ghostie and bandit

Heather Rose and family - Ixodes scapularis adults and larva

Mark Fox - ink drawing of Haemonchus contortus

Alexandra Bryson - Loa loa costume

Kelly Hedlund (submitted by Ryal Relich) - Trypanosoma cruzi crochet art

The Winters - Clonorchis and snail host costumes

Mark Fox and Kristine - our lovely hookworm couple

Piotr Kochan - photography, Ascaris and Giardia

Idzi Potters - photography
'nebula' stool crystal

 Toxocara cati adult worm

 Tunga penetrans

Tunga party!

Melanie Riblett - Easter eggs!

Frances Dodge - photography

And finally, from Sheldon Campbell, the fabulous singing microbiologist:
Click HERE to hear Sheldon live!
Lyrics:

Home in the Gut

Copyright © 2001 by Sheldon Campbell

Oh give me a home where the parasites roam

Where the worms play in cheerful delight

Where the ova are shed, and the larvae are bred

And the pinworms crawl out in the night

Chorus

Home, home in the gut

Where the worms play in cheerful delight

Where the ova are shed, and the larvae are bred

And the pinworms crawl out in the night

Oh hookworm am I, my ova go by

In your stool and then hatch in the mud

They punch through your skin, and migrate again

To the gut, where they suck out your blood

Chorus

I live in the stream of the bile that's green

I'm Clonorchis, so please get it right

And my life's greatest wish is to enter a fish
And then you with your sushi tonight

Chorus

I cling to the wall, a tapeworm so tall

Borne by pork I came to this new home

Now while I procreate, you've got a sure date

'Cause with me you are never alone

Chorus

Please come swim with me, so that we can be free

To burrow into your bare legs
We just copulate, so we can populate

Your liver with our extra eggs

Chorus

The rectum’s my home, but I would love to roam

And lay my eggs out on your butt

I know it’s a bitch, but when you scratch that itch

My kids get into your kid’s gut.