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Image 17:
This聽 male in his 60s, from the Caribbean, was admitted with a nasopharyngeal cancer, with metastases to the spine for which he received corticosteroids and morphine. During a month long admission he developed significant unexplained anemia and severe constipation with intermittent ileus, thought due to his pain medication and spinal lesions. He then developed a cough with purulent sputum and confusion. A sputum culture plate had the appearance seen here.
Diagnosis:
An astute microbiology technologist noted the serpiginous tracts and brought it to the parasitology lab. Several drops of saline were pipetted onto the tract, aspirated and placed on a slide. Under the 22x22mm coverslip 22 filariform and rhabditiform聽Strongyloides聽larvae were counted. No eosinophilia had been noted in multiple examinations over the previous 3 years. This case can be called 'disseminated Strongyloidiasis' or hyperinfection. An agar plate approach to diagnosing stool聽Strongyloides聽larvae has been shown to be relatively sensitive, but is not as sensitive as a good聽Strongyloides听蝉别谤辞濒辞驳测.听听
