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2007 DPDx Case Studies

DPDx Case Studies – 2007

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December 2007

A 52-year-old man was seen at a hospital for fever and chills. He reported travel to wooded areas in the Northeastern United States and noted previous tick bites.

A 29-year-old man, with a history of travel to Rwanda, was seen at a local health clinic for fever, headache, mild nausea, and chills.

November 2007

An asymptomatic, 35-year-old male with no known travel history went to his physician at a wellness clinic for a routine examination. Unusual objects were observed in the formalin-concentrated stool, and the specimen was sent to CDC for diagnostic assistance and possible identification.

A 33-year-old Lithuanian woman had swellings in various regions of her body that developed over the last two years. She reported that she worked as a cook, and she also stated she had traveled to Kazakhstan three years ago.

October 2007

An 18-year-old woman sought medical attention due to a painful lesion between her toes. She reported travel to Africa.

A 49-year-old man, with no known travel history, had a colonoscopy. His physician observed small worms during the procedure that were 3 to 4 mm in length.

September 2007

A 49-year-old man, with no known travel history, had a colonoscopy. His physician observed small worms during the procedure that were 3 to 4 mm in length.

A 10-year-old boy from India was tested for malaria by blood smear examination. The commercial laboratory that reviewed the smears forwarded them, along with EDTA blood, to their state health department for consultation.

August 2007

A 32-year-old man went to his health care provider with complaints of bloating, intermittent diarrhea, and abdominal cramping. He stated he liked to go camping and hunting and sometimes consumed the fish and game that he caught.

A 54-year-old Haitian man was admitted to a hospital emergency room with back pain and fever. Blood was collected, and slides were made and stained with Giemsa.

July 2007

A 29-year-old Peace Corp volunteer returned to the United States from Malawi with symptoms that included mild gastrointestinal cramping and intermittent blood in his urine.

Images captured from a trichrome stained smear were submitted to DPDx for diagnostic assistance. The smears were made from a polyvinyl-alcohol (PVA) preserved fecal specimen, but no other patient or specimen information was given.

June 2007

An immigrant from West Africa arrived in the United States after living in Liberia and Sierra Leone. The individual was admitted to a medical center with shortness of breath and pulmonary tuberculosis was suspected.

A 30-year-old man from Sudan had fever and chills. He was also mildly jaundiced. He went to his physician who ordered a blood smear examination.

May 2007

A mother found objects that she thought were maggots in the diaper of her 10-month-old child. She submitted the specimens to her state health department for identification and advice.

Giemsa-stained thick and thin blood smears were examined as part of a screening protocol for refugees from a country that has areas of ongoing malaria transmission.

April 2007

A patient was seen at a hospital in Rwanda with headache, fever, and chills. A thin blood smear was made, stained with Giemsa, and examined.

A 49-year-old Filipino man had an intestinal tissue biopsy taken. Figures A-C show what was seen on slides stained with hematoxylin and eosin (H & E).

March 2007

Approximately one and a half months after a trip to Costa Rica, a man developed a papule on the back of his right hand. The papule progressed to a 2 cm ulcer with a raised border.

A huntsman killed a bear and prepared it for eating and freezing by cutting it into roasts, steaks, and grinding the trimmings. Later that same day, he ate a burger made from some of the fresh meat and cooked rare. Approximately two and a half to three weeks later, the hunter experienced fever, diarrhea, and muscle pain.

February 2007

A 28-year-old male immigrant who had resided in Spain for the last five years, went to a physician complaining of general malaise and itching. The patient had slight eosinophilia but 15 days later was asymptomatic with no alteration in the differential blood count.

The Division of Parasitic Diseases' reference diagnostic laboratory received a specimen from a state health department for confirmatory review. The only patient information given was that the patient had traveled to Nigeria.

January 2007

A missionary traveled to various countries in sub-Saharan Africa for one year. He went to his physician complaining of abdominal pain and occasional diarrhea which he experienced since his return to the U.S.

A patient complaining of intermittent symptoms including coughing up blood, fever, and other vague "flu-like" symptoms saw a physician. The patient reported working at a sushi restaurant and eating a raw crab on a dare.

DPDx is an educational resource designed for health professionals and laboratory scientists. For an overview including prevention, control, and treatment visit www.cdc.gov/parasites/.