Case 45
A middle-aged couple from Delaware had taken a ten-day Middle Eastern vacation in Iran, Iraq, Jordan, and Egypt.  Three months after their return, the couple was scheduled for routine annual physicals.  The woman told the nurse that she had been experiencing intermittent mild abdominal cramping and occasional loose stools.  Her husband was not sick.  Stool specimens were collected from the couple as part of the physical examination, along with other tests such as blood chemistries, EKG, and so on.  The objects in Figures A and B were found in both stool specimens after an FEA (formalin-ethyl acetate) concentration procedure.  What is your diagnosis?  Based on what criteria?

A	B

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Case 46
A 14-month-old toddler was admitted to a hospital in Jamaica with a high fever and neurological abnormalities of unknown origin.  A spinal tap was performed and, based on the results, the child was diagnosed with eosinophilic meningitis (more than 10% of white blood cells were eosinophils).  The child died three days after being admitted.  A brain biopsy revealed the following structures (Figures A and B).  Findings from the epidemiological investigation conducted indicated that the infection was strongly associated with the ingestion of uncooked vegetables where snails or slugs may have been present.  What is your diagnosis?  Based on what criteria?

A	B

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