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Case #455 – November, 2017

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. The submission form indicated that how and where the worms were collected was not provided by the commercial laboratory. Figure A shows all three worms for gross presentation and size determination. A dissecting microscope was used to observe morphologic features. Figures A and B shows two separate focal planes of the anterior of one worm; Figures C, D and E show three aspects of the tail. What is your diagnosis? Based on what morphologic features.

Parasitic image

Figure A

Parasitic image

Figure B

Parasitic image

Figure C

Parasitic image

Figure D

Parasitic image

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/.