Case #477 – October, 2018

A 58-year-old male, with recent travel to Asia, was seen at an out-patient clinic for abdominal discomfort that lasted for two days. A stool sample was collected in 10% formalin and zinc PVA (Zn-PVA) and processed for ova and parasites (O&P) examination. A presumptive worm egg was recovered from the stool and was processed in the pathology laboratory for identification. An image of the hematoxylin and eosin (H&E) stained slide is shown in Figure A. What is your diagnosis? Based on what morphologic features?

This case and image were kindly provided by the Digestive Healthcare of Georgia, PC.

Figure A

This was a very interesting case of a plant seed that resembled a worm coiled inside an egg. Morphologic features included:

Rectangular plant cells.
Meristem (growing tip) between the bifurcated developing seed-leaves (blue arrow).
Seed coat (green arrow)

parasitic image

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/.