Case #386 – December 2014

For the last Monthly Case Study for 2014, the DPDx Team thought we would fill your holiday stockings with a plethora of parasites! The following images were taken from a trichrome-stained stool specimen collected from a Haitian refugee. The original report documented several intestinal protozoa. How many can you identify?

Figure A

Figure B

Figure C

Figure D

Figure E

Figure F

The images in this case showed the following intestinal protozoa:

cysts (Figure A) and trophozoites (Figures D and E) of Entamoeba coli (Ec). Notice the presence of six nuclei in the cyst in Figure A.
cysts of Giardia duodenalis (Gd, Figures A, B, C, and E).
binucleate trophozoites of Dientamoeba fragilis (Df, Figures B and D).
cysts of Blastocystis hominis (Bh, Figure C).

As an added bonus, the E. coli trophozoite in Figure F has ingested a G. duodenalis cyst!

Figure A

Figure B

Figure C

Figure D

Figure E

More on: Blastocystis hominis; Dientamoeba fragilis; Giardiasi; Intestinal amebae

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.