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Case #233 – August, 2008

A 37-year-old man began experiencing severe diarrhea about one week after attending a family social event. At the request of his medical provider, a fecal specimen collected in the two-vial system consisting of one vial with 10% formalin and one vial with Zn-PVA (zinc-based polyvinyl alcohol) was submitted for examination. An FEA concentration procedure and wet mount examination was done on the formalin preserved specimen. Figures AC shows structures that were found in moderate numbers at 1000x magnification. The structures measured about 8-10 micrometers in diameter. A smear was made from the specimen preserved with PVA and stained using trichrome. Figures D and E show similar round objects that were observed. What is your diagnosis? Based on what criteria? What other testing methods would you suggest?

Case233_A

Figure A

Case233_B

Figure B

Case233_C

Figure C

Case233_D

Figure D

Case233_E

Figure E

Images presented in the DPDx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.

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/.