Case #449 – August, 2017

A seven-year-old female from Sudan had a stool examination as part of a refugee screening. Her blood workup also revealed elevated eosinophils. A formalin-ethyl acetate (FEA) concentration was performed on the stool specimen and Figures A – D show what was found on a wet mount preparation. What is your diagnosis? Based on what morphologic features?

This case was kindly contributed by the State Hygienic Laboratory, University of Iowa.

Figure A

Figure B

Figure C

Figure D

This was a case of schistosomiasis and giardiasis caused by Schistosoma mansoni and Giardia duodenalis. Diagnostic features included:

Eggs containing a miracidium and presenting a prominent lateral spine consistent with S. mansoni eggs
(Figures B and C, slightly obscured in Figure A).
Oval to ellipsoidal cysts (Figure D) with fibrils and nuclei consistent with G. duodenalis.

For more on schistosomiasis: https://www.cdc.gov/dpdx/schistosomiasis/index.html

For more on giardiasis: https://www.cdc.gov/dpdx/giardiasis/index.html

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/.