Case #434 – December, 2016

A patient had two stool specimens submitted for ova and parasite (O & P) examination. Smears were made, stained with trichrome, and examined. Eosinophils and Charcot-Leyden crystals were observed in both specimens. Also observed, at 1000x oil magnification, were the objects in Figures A and B. They measured 10 µm in diameter on average. What is your diagnosis? Based on what criteria?

Figure A

Figure B

The objects presented in this case were artifacts and appeared to be spores of Reshi mushrooms. Although they show a striated outer wall similar to Taenia sp eggs, the shape is ovoid and the size of approximately 10 micrometers is too small. The North Dakota Department of Public Health, in follow-up, contacted the submitting facility to inquire about patient history and any dietary supplements the patient was taking. They were informed that the patient drinks coffee with four kinds of mushrooms including Reishi mushrooms, which confirmed their diagnosis that the objects were some type of spore or pollen.

This case and images were kindly provided by the North Dakota Department of Public Health.

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/.