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2017 DPDx Case Studies

DPDx Case Studies - 2017
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December 2017

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A nine-year-old female refugee from Eritrea with neutropenia and eosinophil counts within normal range had a stool examination as part of a refugee screening.

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A 69-year-old male, with recent travel to Peru, was undergoing a routine colonoscopy performed as a screen for colorectal cancer.

November 2017

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A state public health laboratory received three worms from a regional commercial laboratory for identification. The public health laboratory submitted the worms to the CDC/DPDx Team for diagnostic assistance.

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A four-year-old child from Ethiopia had a stool examination as part of a standard refugee screening. A fecal specimen was collected in zinc polyvinyl alcohol (Zn-PVA) fixative and in 10% formalin.

October 2017

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A 38-year-old asplenic man residing in California was hospitalized with a 104º F fever, hematuria, myalgia, fatigue and thrombocytopenia.

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An eleven-year-old male from Arizona with no known past medical history was evaluated in the ophthalmology clinic after a 3-4 week history of progressive redness in his left eye, with associated pain and growth of a nodule.

September 2017

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Two maggots were retrieved from a wound in an elderly woman living in rural Manitoba.

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A man, with no reported travel outside of Canada and who was immunocompetent, had complaints of abdominal cramping and diarrhea that had been ongoing for more than two weeks.

August 2017

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A seven-year-old female from Sudan had a stool examination as part of a refugee screening. Her blood workup also revealed elevated eosinophils.

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A 26-yo man, who recently emigrated from Northern Africa, presented to his primary care provider with complaints of abdominal pain, diarrhea, and weight loss for the preceding 6-8 months. He was later found to be leukopenic, neutropenic, with elevated eosinophils in the peripheral blood.

July 2017

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An engorged tick was delivered to a laboratory for identification.

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A lung biopsy was obtained on a 29-year-old-patient from Cameroon with cough, dyspnea, and hemoptysis.

June 2017

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Several people developed gastrointestinal symptoms of watery diarrhea, nausea with vomiting, and low-grade fever approximately 1 week after attending a catered event. Stool specimens were collected for laboratory testing which included a formalin-ethyl acetate concentration with brightfield wet mount examination.

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Blood specimens were collected at night from members of a village in Myanmar endemic for lymphatic filariasis. Roughly one-third of the cases were symptomatic, with or without recurrent episodes of fever and various degrees of lymphedema.

May 2017

Case 443

A 7-year-old female who had recently moved from the Democratic Republic of Congo to the US was treated for mild, non-immune hemolytic anemia and appeared to be in stable condition.

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A 37-year-old male immigrant from the Middle East sought medical attention for pain in the upper right abdominal quadrant. Ultrasonography revealed a single compartment hepatic cyst approximately 7 cm in diameter and during the imaging, a fine biopsy needle was used to obtain an aspirate specimen.

April 2017

A patient, who lives in a rural region in South America, presented with bloody diarrhea and remembers having eaten undercooked pork. The attending physician submitted images to the DPDx Team of a roundworm he observed during a colonoscopy.

A 6-year-old child from a community in rural southeastern United States presented with severe upper right abdominal pain, fever, chills, decreased appetite and weight loss. The child expired 2 weeks after being admitted for symptoms that included hepatitis.

March 2017

A 29-year-old male immigrant from Nigeria presented to an emergency room with fever, splenomegaly, jaundice, and neurologic changes.

Stool specimens were collected from an asymptomatic 10-year-old boy from Panama as part of a refugee screening program. The stool was collected in 10% formalin and zinc PVA (Zn-PVA) and sent to the county health department for routine ova-and-parasite (O&P) examination.

February 2017

A 31-year-old female, with travel to Mexico a few months prior, noticed a small worm-like object on the inner surface of her lower lip.

A 36-year-old male immigrant, with an elevated eosinophil count, was suspected of being infected with pinworms and was administered a pinworm paddle test.

January 2017

An adult patient with right eye and eyelid irritation sought medical attention at an eye clinic. Upon examination, living organisms and what appeared to be egg cases were identified on the patient's eyelids and eyelashes.

An immigrant from Korea presented with calculi in the intrahepatic biliary passages, cholangitis and early stage cholangiocarcinoma.

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/.