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2011 DPDx Case Studies

DPDx Case Studies – 2011

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December 2011

A 29-year-old woman was seen by the medical unit at the U.S. Embassy in Indonesia for symptoms that included diarrhea for two weeks and vomiting for four days.

A 25-year-old man sought medical attention for a nodule on his right hand that had developed about a year after returning from travel to Liberia.

November 2011

A 55-year-old homebound Type II diabetic, originally from Haiti, was hospitalized for severe abdominal pain and hematemesis.

A 27-year-old patient with multiple myeloma presented with respiratory problems and disseminated lesions over various parts of his body post stem-cell transplant.

October 2011

A 19-year-old male presented to his health care provider with moderate abdominal cramping and intermittent diarrhea that started approximately one week following a camping trip in the southeastern United States.

A 42-year-old photographer, who is known to travel to remote locations in tropical regions, presented to her health care provider with mild, intermittent abdominal cramping and low grade fever.

September 2011

Stool specimens were collected from Haitian patients at a refugee clinic for routine ova-and-parasite (O&P) examination. The stool specimens were collected in 10% formalin and polyvinyl alcohol (PVA) and sent to the county public health laboratory for processing and examination.

A 27-year-old patient underwent chemotherapy and a bone marrow transplant after being diagnosed with leukemia. Approximately two months after the bone marrow transplant, the patient was admitted to the hospital.

August 2011

A twenty-year-old male from India presented with recurrent abdominal pain. He underwent an appendectomy at a local medical center.

A 41-year-old woman from the Amazon region of Brazil presented at a local hospital with fever, chills, and myalgia.

July 2011

A 51-year-old man was brought to the emergency room after a friend noticed he was minimally responsive. The friend explained that the patient had been suffering from upper respiratory symptoms and mild fever for about three weeks, and a progressive cough for about one week.

The DPDx Team received images from a hospital in the Netherlands for diagnostic assistance to identify an arthropod. The arthropods were presented to the hospital by a lady who found them under her mattress.

June 2011

A 27-year-old male from Cameroon, who immigrated to the U.S. six years ago, presented to his health care provider with ocular pain and swelling. He told his health care provider that he had an episode of "a worm crawling in his eye" three years prior.

A 42-year-old man presented to his health care provider with fever, chills, and mild myalgia. He mentioned that his occupation requires frequent travel to Indonesia and Malaysia and that he often does not take any malaria prophylaxis.

May 2011

A 47-year-old man, originally from Thailand, presented to the hospital with upper abdominal pain accompanied with liver enlargement. A biopsy of the bile duct revealed fibrotic thickening. The biopsy specimen was sent to Pathology for routine sectioning and staining.

Stool specimens were collected for routine ova-and-parasite (O&P) examination by a local health department as part of a refugee screening program. Specimens were collected in 10% formalin and polyvinyl alcohol (PVA) and sent to the state health laboratory for processing and examination.

April 2011

A 41-year-old woman presented to her health care provider with ulcerative lesions on her left ear and neck. Travel history included an excursion along the Amazon River in Brazil four months prior.

A 34-year-old man presented to his health care provider with a lesion with a dark center on his right hallux (big toe) that was inflamed and painful. Travel history included Panama and Ecuador one month prior.

March 2011

A hospital laboratory sent a tube of EDTA blood and Wright-Giemsa stained blood smears (thick and thin) to the DPDx Team for malaria confirmation/identification. No travel history was available.

A 30-year-old man presented to his primary care provider with abdominal pain, fatigue, and diarrhea (sometimes tinged with blood). The patient had recently returned after two weeks in Armenia.

February 2011

A seven-year-old child was taken to the doctor for abdominal pain, gas, bloating and intermittent diarrhea. The symptoms started about two days after returning from summer camp.

A 45-year-old woman, originally from Africa, presented to her primary care provider with diarrhea, nausea, vomiting, weight loss and gastritis. The symptoms occurred approximately three months post kidney transplant.

January 2011

A state health laboratory sent a formalin-ethyl acetate (FEA) stool concentrate to the DPDx Team for Entamoeba confirmation/identification.

Upon returning from a week-long business trip to Las Vegas, a 35-year-old man found what appeared to be insects among various articles of clothing.

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/.