Case #349 – June, 2013

A 59-year-old foreign correspondent sought medical attention from his health care provider for intermittent hematuria which had started while on an assignment in Malawi. A urine specimen was collected, concentrated by centrifugation, and examined microscopically. The objects shown in Figures A–C were observed in moderate numbers and measured 160 micrometers long on average. What is your diagnosis? Based on what criteria?

Figure A

Figure B

Figure C

The objects presented in this case were crystals, possibly of uric acid, and a diagnosis of No Parasites Found was given. Although the general shape and size of these crystals was similar to the eggs of Schistosoma haematobium, they lacked a terminal spine and miracidium.

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/.