DIFFICULT ROUND

Parasitology
A 67-year-old female presented with a 2-3-day history of lower back pain. She also reported a burning
sensation all over her body. The patient’s history included emphysema of the lungs, history of smoking,
pancreatitis, and cholelithiasis. She underwent endoscopic retrograde cholangio-pancreatography
(ERCP) at which time a worm was detected in the common bile duct and removed. The worm was
damaged during retrieval but images were taken of what was obtained and sent to the DPDx Team for
diagnostic assistance. Figures A and B shows the portion of the worm recovered.
Morphologic features shown included:
1. A short, muscular, bulb-shaped esophagus.
2. A marked, anterior “hook” shape.
3. A large buccal cavity with cutting plates.
Further clinical history of the patient included a history of Helicobacter pylori and hookworm
infections. In addition, a follow-up stool specimen was received on the patient and hookworm eggs were
observed on a concentrated wet-mount.

FIGURE A FIGURE B
Determine the following:
A. Name of the parasite.
B. Parasitic worms are also known as?