Case 29
A 3-year-old girl was seen in a small rural clinic in the Southeastern United States with complaints of abdominal pain and upset stomach.  A local laboratory performed a routine stool examination and observed the objects shown in the images below.  The laboratory suspected the objects were artifacts.  A portion of the stool concentrate was sent to CDC's reference laboratory for confirmation that parasite cysts or eggs were not present.  What is your diagnosis?  Based on what criteria?

A	B

C	D

Click here for the answer to Case 29.

Case 30
Two sisters in their early twenties from Dallas, Texas, went on a ten-day ecotour in Costa Rica.  They camped in a tent during most of the trip.  The sisters complained of being bitten by various insects during the entire trip.  Two months after returning from the excursion, both women noted several small, ulcerated sores on their wrists and necks.  They went to a local dermatologist who examined their sores.  The physician made touch-prep impression smears from sores of each patient’s wrist by pressing a 1” × 5” glass slide against the sores.  The images below show impressions from each woman (Figures A and B, Giemsa stain).  The physician also took a few small biopsies from the base of the sores on each woman's wrists and neck.  Some of the tissue was sent to the pathology lab where it was sectioned and stained with H & E (hematoxylin and eosin), see Figures C and D.  The remaining specimens were individually placed in sterile saline and then refrigerated at 4°C.  What is your diagnosis?  Based on what criteria?

A	B

C	D

Click here for the answer to Case 30.