Case #212 – September, 2007
A 38-year-old man sought medical attention because of rectal bleeding. His only reported travel was to Laos two years ago. A colonoscopy was performed and based upon what was found during the procedure, he was given a presumptive diagnosis of tapeworm. The largest object recovered during the colonoscopy measured approximately 0.7 cm in length and 0.05 cm in diameter. Figures A and B, taken at 100× and 400× magnification respectively, were two of the images submitted to DPDx for diagnostic assistance. The DPDx Team concurred with the presumptive diagnosis but required actual specimens for examination to make a more specific identification. Figures C-E, taken at 100×, 400×, and 1000× (oil) magnification respectively, show what was observed on the hematoxylin and eosin (H & E) stained slide sent to CDC. The round to oval structures measured 35 to 40 micrometers in diameter. What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Figure D
Figure E
This case was kindly contributed by Dr. R Worthington at Sheboygan Memorial Hospital.
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.