Case #226 - April, 2008
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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. The images in Figures A and B show forms that were observed in very low numbers on the smears. Figures A and B were captured at 200x and 1000x oil magnification, respectively. The object measured approximately 490 micrometers in length. What is your diagnosis? Based on what criteria?
Figure A
Figure B
Case Answer
This was a case of strongyloidiasis caused by Strongyloides stercoralis. The larva shown in the images was a filariform (infective third-stage form) larva. Diagnostic features included:
- the length of the larva being within the size range for the species.
- the esophagus to intestine ratio, which was roughly 1:1 (Figure A).
- the characteristic notched tail of filariform larvae of S. stercoralis (Figure B).
Figure A
More on: Strongyloidiasis
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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