Trypanosoma sp in peripheral blood.

Trypanosomiasis which is spread by tsetse flies in a rather interesting way! After the fly bites someone, it defecates near the bite site and that is where this protozoan parasite can be found. The bite is painful and people smear said parasite into the wound when scratching it. The trypanosomes then spread to the nervous system, causing lethargy, tremors and confusion, and eventually coma and death. 

Larval Echinococcus granulosus, light micrograph.

Let’s do another story.

There was a cancer patient who had one day, in the middle of her chemo, discovered a mass in her breast. Thinking this was a tumor, the doctors decided to go in and do a biopsy. The surgeon cut just a little bit below the mass, expecting to do a regular biopsy, when a hydatid cyst full of tiny dog tapeworm larvae explodes out of the incision. The surgeon freaks out and sucks most of them up but manages to save enough to send to the lab to make a diagnosis.

What the heck? Let’s look into the history.

Not too long ago, her dog had died of unexplained seizures (no autopsy). Turns out, she had been in Aruba not too long ago and one of the two got infected and passed it on. When she went onto chemotherapy, it knocked out her immune system enough that the parasite began to flourish.

Trichomonas vaginalis, the causative agent of trichomoniasis, which is more common than you might expect! 

In our micro department, when you work nights, your whole shift is basically looking at genital smears. This is not a very exciting shift so a very bored someone (not me) took a wet mount positive slide and put iodine at one end of the coverslip. She then watched the advancing iodine front as it made all the jiggling trich seize up and die what looked like a painful death on contact.

Light micrograph of adult intestinal blood flukes, Schistosoma mansoni. The adults (male thick & bluish, female white & threadlike) normally live in pairs in blood vessels of the small intestine, causing dysentery & diarrhoea. Their spiked eggs cause anaemia, inflammation & tissue scarring. The brown pigmentation is a blood meal.

After picking up a leaky urine that was submitted for schistosomiasis testing, I have officially reached that point in my life where things that are wet and are not supposed to be wet will gross me out because they remind me of my daily pile of leaky containers.

Coloured SEM of a macrophage engulfing a mauve Leishmania sp. parasite.

Trichinella spiralis encysting in some muscle with a routine H&E stain.

When doing Ova and Parasites, patients fill out a history form for us. Either many seem to think it is a joke or our form is not very good. One time, someone put “Narnia” as their last travel destination. And for the yes/no question of “known carrier?”, people like to write, “Air Canada”. Although these botched forms are not useful, I still enjoy reading them. 

medicalstate:

Ascaris lumbricoides.

Perhaps I could do one better than just ruining spaghetti. These parasites really don’t like a lot things you put in your body. This was before my time and the story was passed down to me by the clinical microbiologist one day, and I can’t put this under a jump because of Tumblr’s silliness.

The first story is one of the patients in the university hospital who decided to go outside for a smoke. Cigarettes are one of the things ascaris doesn’t like. So in the middle of his smoke, they decided to peace out of him, and suddenly there were worms crawling out of his butt and flopping onto the pavement.

Not enough? There was a little boy with some other form of infection that I don’t recall, but they started him on treatment and, unsurprisingly, the at-the-time-unknown ascariasis didn’t like that either! They didn’t come out the bottom end though. They came crawling out of his nose and mouth.