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Case #411 - January 2016

Case Description

A 23-year-old female with no documented travel history presented with iron deficiency anemia and periodic abdominal pain. Ova-and-parasite (O&P) examinations of stool were negative. A colonoscopy was performed and a worm-like object (Figures A and B) was observed attached to the mucosa of the ascending colon. The object was removed, sent to Pathology, and processed by routine histologic work-up. Figures C-E show what was observed by the pathologist after sectioning and staining with hematoxylin-and-eosin (H&E). Images were captures and sent to the CDC-DPDx for diagnostic assistance. What is your diagnosis? Based on what criteria?
Figure A

Figure A

Figure B

Figure B

Figure C

Figure C

Figure D

Figure D

Figure E

Figure E

Case Answer

This was a case of hookworm infection, caused by either Necator americanus or Ancylostoma duodenale. Diagnostic morphologic features included:

  • platymyarian somatic musculature (MU, Figure D)
  • multi-nucleated intestinal cells with a brush border (IN, Figure D)
  • the presence of a copulatory bursa (Figure E), indicating the specimen was a male. The bursa, as presented in these images, is suggestive of Ancylostoma, being wider than long.

Figure D
 

More on: hookworm

Answer Figure D

Answer Figure D

Acknowledgements

This case and images were kindly provided by St. David’s South Austin Medical Center, Austin, TX.

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DPDx is an education resource designed for health professionals and laboratory scientists. For an overview including prevention and control visit www.cdc.gov/parasites/.

  • Page last reviewed: August 24, 2016
  • Page last updated: August 24, 2016
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