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Case #419 – May 2016

A 23-year-old female presented to her primary care provider with abdominal pain, cramps, flatulence, and diarrhea five days after returning from a white water rafting trip in the Grand Canyon, Arizona. Stool specimens were collected in 10% formalin and zinc polyvinyl alcohol (Zn-PVA) and sent to a reference lab for routine ova-and-parasite (O&P) testing. Figures A-D show what was observed on a trichrome-stain slide of stool preserved in the Zn-PVA. Images were captured at 1000x magnification with oil. What is your diagnosis? Based on what criteria?

Figure A

Figure B

Figure C

Figure D

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/.