Case 61
A male CDC employee had diarrhea for six weeks before consulting the occupational health clinic.  He had traveled to several different African countries a few weeks prior.  His symptoms included abdominal cramps and frothy stools.  The man treated himself with metronidazole without improvement.  A stool specimen preserved in zinc polyvinyl alcohol (Zn-PVA) was submitted to the reference laboratory for diagnostic evaluation.  Smears were made from the specimen, stained with trichrome, and examined.  The QuickTime movie clip (Figure A) below shows an example of cyst-like organisms, averaging 13 to 14 micrometers in diameter, that were found in moderate numbers in the trichrome stained smear.  The movie clip simulates focusing through several planes when you move the slider control of your viewer back and forth.  Figures B and C show examples of a different stage of the same or similar organisms, averaging 15 to 16 micrometers in diameter.  What is your diagnosis?  Based on what criteria?

QuickTime is required to view the movie clip.  If you do not have QuickTime 5.0 or greater, you can download it free from http://www.apple.com/quicktime/download/.

A

After the video clip plays through one time, you can right click on the image and choose play to watch the video again.

B	C

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Case 62
An adult female was diagnosed with malaria.  Her travel history included trips to Ghana and Sierra Leone.  The hospital laboratory consulted CDC after getting clearance from the state health department for assistance in identifying the species responsible for this case.  The original blood smears were sent to CDC along with whole blood in EDTA for confirmation.  What is your diagnosis?  Based on what criteria?

A	B

C	D

E	F

G	H

I

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