A state health laboratory received stool specimens collected in in sodium acetat

Question

A state health laboratory received stool specimens collected in in sodium acetate-acetic acid-formalin (SAF) for ova-and-parasite (O&P;) examination. The patient was an immigrant, but his specific country of origin was not known. The stool was processed by formalin-ethyl acetate (FEA) concentration and trichrome staining. The attending microbiologist observed what she believed to be trophozoites of an Entamoeba species in both the wet mount from the FEA and the trichrome-stained smear; no cysts were observed. Digital images of the suspect amoebae were captured and sent to the DPDx Team for diagnostic assistance. Figure A shows what was observed in an unstained wet mount of the FEA concentrate; Figure B is also from the wet mount, but stained with iodine. Figures C and D show what was observed on the trichrome-stained slide 1. What is your diagnosis 2. Based on what criteria? 3. What is a alternative that you considered, but discounted?

Explanation / Answer

This patient is suffering from the Amebiasis caused by the Entamoeba histolytica

Entamoeba histolytica is well recognized as a pathogenic ameba, associated with intestinal and extraintestinal infections.

Given slided are showing the trophozoites of Entamoeba histolytica/dispar.

Diagnostic morphologic features included:

·         trophozoites within the size range of Entamoeba histolytica/dispar

·         a single nucleus with evenly-distributed peripheral chromatin and a discrete karyosome that is centrally (or slightly eccentrically) located.

I am considering the Giardiasis Alternatively

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