Case #314 – December, 2011

A 25-year-old man sought medical attention for a nodule on his right hand that had developed about a year after returning from travel to Liberia. The nodule was surgically excised and a tangled mass of thin, white worms was observed within. The worms were preserved in 10% formalin and sent to CDC-DPDx for identification. Figure A shows the mass of worms; Figures B and C show what was observed at 100x after partial clearing in lactophenol. What is your diagnosis? Based on what criteria?

Figure A

Figure B

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.