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Case #508 – January, 2020

A 69-year-old male patient from a rural town in Georgia experiencing symptoms of productive cough with blood, hematochezia (rectal bleeding) and chest pain sought medical attention at the county health clinic. He had no known travel history. A bronchoalveolar wash specimen was collected in Total-Fix® and sent to the laboratory for analysis. Microscopic examination of a wet mount preparation revealed what is shown in the following images (Figures AC) captured at different magnifications. The organisms measured 271-378 µm. What is your diagnosis?  Based on what criteria?

Figure A

Figure A

Figure B

Figure B

Figure C

Figure C

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/.