Case #251 - May, 2009
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A 45-year-old pig farmer from rural Georgia presented to his health care provider with abdominal pain, cramps and diarrhea. Stool specimens were collected in polyvinyl alcohol (PVA) and 10% formalin for ova and parasite (O&P) examination. The objects in Figures A and B, which measured on average 90 micrometers in length, were observed in low numbers in formalin-concentrated wet mounts of the stool. The objects in Figures C and D, which measured on average 12 micrometers in diameter, were seen in moderate numbers on trichrome-stained slides prepared from the PVA-preserved stool. What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Figure D
Case Answer
This was a case of balantidiasis, caused by Balantidium coli (Figures A and B); also observed were cysts of Entamoeba polecki (Figures C and D). Diagnostic features included:
- ciliated trophozoites of B. coli (Figures A and B) containing a cytosome and macronucleus, and within the size range (40-200 micrometers) of the species.
- uninucleate cysts of E. polecki (Figures D and E) containing a nucleus with a pleomorphic karyosome and evenly-distributed peripheral chromatin, and many irregularly-shaped chromatoid bodies, as well as being within the size range (11-15 micrometers) of the species.
More on: Balantidiasis: Entamoeba polecki
Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.
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