2008 DPDx Case Studies

A nine-year-old boy from Central America, who had recently immigrated to the United States with his family, was taken to a local health facility with complaints of intestinal cramping and intermittent diarrhea.

A small, cream-colored worm-like object was discovered in the diaper of a 15-month-old child. The suspect worm was collected by the child’s parents and sent to the State Health Department for identification.

A 45-year-old immigrant from Mexico was admitted to the hospital after experiencing headaches, fever, pulmonary symptoms, and adenopathy. Because of his travel history, a blood specimen was collected and sent to Hematology for routine work-up, including blood parasitology.

A 50-year-old man went to his health care provider after a week of intermittent diarrhea, cramps and nausea. Stool specimens were collected over three consecutive days and sent to the local public health laboratory for routine ova and parasite (O&P) work-up.

A 45-year-old man from Kenya who was visiting relatives in the New England area had complaints of fever and headache. He was taken to a nearby hospital for medical evaluation.

A 28-year-old man had loss of appetite, weight loss, and intermittent diarrhea approximately one week after attending a family reunion located on a farm in the mid-western U.S. He sought medical attention with his primary care provider who collected a stool specimen for ova and parasite (O&P) examination using a single-vial fixative system.

A 30-year-old who frequents sushi restaurants started experiencing severe gastritis, including epigastric pain, nausea and vomiting. He had reported eating at a sushi restaurant the previous day.

A 25-year-old man returned from three months of studying abroad in southeast Asia. Countries he visited during his studies included the Philippines, Indonesia and Thailand. Shortly after returning to the United States, he presented to his health care provider with abdominal pain, cramps and diarrhea.

A 29 year-old man with travel history to Costa Rica, Belize, and Nicaragua developed an ulcerative lesion on his right foot. The lesion did not respond to over-the-counter medications so the patient went to his health care provider.

A 37-year-old man began experiencing severe diarrhea about one week after attending a family social event. At the request of his medical provider, a fecal specimen collected in the two-vial system consisting of one vial with 10% formalin and one vial with Zn-PVA (zinc-based polyvinyl alcohol) was submitted for examination.

A study was conducted on herding dogs in a sheep-raising region of northeastern Arizona to determine the prevalence of Echinococcus granulosus. Public health officials wanted to determine the risk for hydatid cyst disease in the local people.

A 25-year-old man, who recently returned from a trip to Brazil, presented to his health care provider with a festering lesion on his forehead. The patient also complained of feeling things moving under his skin.

A 29-year-old man presented to his physician with recurring abdominal cramping, watery diarrhea, and general fatigue. A stool specimen was collected for ova and parasite testing.

Wright-Giemsa stained blood smears and EDTA blood were sent for confirmatory diagnosis to the CDC from a Public Health Laboratory. The specimens were from a 46-year-old woman, but no travel history was available.

Within a week of returning from a conference in Mexico, a 28-year-old woman presented to her primary care physician with cramps, abdominal pain, gas and diarrhea. A routine Ova and Parasite (O&P) examination was performed on stool specimens.

A 19-year-old male from Louisiana with no known travel history outside the United States presented to his health care provider with a one-month history of headache, fatigue, shortness of breath and weight-loss.

A 32-year-old Latin American man sought medical attention for persistent fever and cough. A sputum specimen was collected for testing. Smears were prepared and stained with Giemsa.

An 8-year-old child was taken to a hospital with fever, hepatomegaly, and persistent cough. The parents told the physician that the child commonly eats dirt, even though they have tried to discourage the habit.

A 47-year-old male with travel history to the Galapagos Islands, Ecuador and Colombia presented to his health care provider with follicular conjunctivitis. A worm-like object measuring approximately 3.0 mm was removed from his eye and sent to a pathology laboratory for analysis.

A seven-year-old, previously healthy child developed flu-like symptoms and rapidly progressive bulbar palsy, coma, and eventually death. Imaging revealed florid ventriculitis. A viral etiology was initially suspected.

Images were taken from a thick blood smear stained with hematoxylin from an adult male from Cameroon. The following images, A-C were all captured from the same field of view.

A survey was conducted to determine the prevalence of geohelminth infections in school-age children living in Haiti. The laboratory aspect of the survey consisted of processing stool specimens which were collected in 10% formalin.

A woman found a worm in her laundry basket and contacted the health department in her state for assistance. She reported small children in the household, as well as dogs and cats.

Five hunters spent a weekend in a cabin in the Northeastern United States. One of the hunters, who slept in a sleeping bag on the floor of the cabin, awoke in the morning with a rash on various parts of his body (Figure A).