Case Study

Case Study 2



An unpreserved stool sample arrives in the clinical laboratory of San Lazaro Hospital at
10:30 A.M. The requisition slip and sample are properly labeled with the patients name,
hospital number, physician and time of collection (11:30 P.M.) The request is for an ova and
parasite exam. The specimen within the container appears to have a watery consistency.

Questions

1. Should the specimen be processed for ova and parasite exam?


No. Because the sample shall be collected for at least 3 days after the patient has received
barium, oil, magnesium or other crystalline compounds. Moreover, the sample must be stored at
room temperature until delivered to the lab within 3 days and the stool sample should be hard
enough to be broken down by the scoop spoon.

2. What form of the protozoan parasite would you expect to find?

On this case, you might find a Entamoeba histolytica (an amoeba), and Giardia lamblia (a
flagellate).

Case Study 3
A 24-year old hiker had recently returned from a camping trip to Colorado. While
camping, she had obtained drinking water from an untreated stream. Several weeks after
returning home, she presented to her family physician with profuse, watery diarrhea,
crampy abdominal pain, and foul-smelling flatulence.

Stool specimens were negative for enteric bacterial pathogens, but wet mounts
demonstrated binucleate pear-shaped trophozoites showing a "falling leaf" type of motility.
A permanent trichrome stain confirmed the diagnosis.

Questions:

1. What is the name of the parasite causing the patient's illness? What is the infectious
stage of this parasite?

The parasite is Giradia lamblia the infective stage of the parasite is the cyts that are transmitted
through fecal-oral route.
 Case Study

2. How does this parasite avoid being dislodged by intestinal peristalsis?




The Giardia trophozoites attach to the epithelium of the small intestine using a specialized
cytoskeletal structure termed the ventral disc. This attachment is critical for the parasites to avoid
being dislodged by peristalsis.

3. How does this parasite sometimes result in malabsorption?




Because of the inflammation of the G.I tract, malabsorption of fats and carbohydrates is
particular causing the patient with steatorrhea or passage of greasy, and frothy stools.

4. How is this parasite transmitted? How can transmitted be prevented?




The parasite is transmitted through the ingestion of cyst from contaminated food and water.
Thus, reducing this contamination is the best method of prevention. Filtering or purifying
drinking water in endemic areas is important. Proper sanitation is also needed. Proper
handwashing can help to break the cycle of transmission.

5. How is this illness treated?

It can be treated using the drug of choice which is metronidazole. The furazolidone maybe used
especially for children under 5 years old.