Contributed by Bobbi Pritt, M.D. and Heather Arguello
Double walled cyst and trophozoite
Contributed by Natalie Larsen, M.D. and Sixto M. Leal, Jr., M.D., Ph.D.
Inflammation surrounding filamentous bacteria
Sulfur granule formation in tonsillar tissue
Contributed by Patricia Tsang, M.D.
Case of the Month #486
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HGA: inclusions in granulocytes
Left: HGA (HGE)
Contributed by Rubens Rodriguez, M.D., Ph.D.
Colonic pseudotumor
Cecal pseudotumor
Small bowel thickening
Small bowel infarction
Small bowel perforation
Contributed by Rubens Rodriguez, M.D., Ph.D.
Arterial thrombosis
Eosinophilic arteritis
Severe eosinophilic infiltration
Vascular granuloma and eosinophils
Vascular granuloma and eosinophils
Granuloma with degenerated egg
Degenerated egg
Eggs and eosinophils
Adult worm inside artery
Adult worm inside artery
Degenerated worm
Severe eosinophilic infiltration
Adult worm
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Epithelial cell in stool
Fungal spore in stool
Fungal element in stool - AFP stain
Pollen grain in stool
Plant hair in stool
Platelets in blood
Nucleated RBC in blood
Contributed by Bobbi Pritt, M.D.
Adult with 3 fleshy lips
Contributed by Bobbi Pritt, M.D. and Institute of Tropical Medicine Antwerp
Ascaris lumbricoides eggs, decorticated
Creepy Dreadful Wonderful Parasites Case
Contributed by Erika Wheeler, M.D. and Bobbi Pritt, M.D.
Intracellular and extracellular Babesia ring forms
Multiple Babesia ring forms
Giemsa stained thick and thin blood films
Giemsa stained thick and thin blood films
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Tetrad form
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
B. mandrillaris trophozoite and cysts
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Life cycle
Contributed by Bobbi Pritt, M.D. and Blaine Mathison
Trichrome stained stool specimen
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4 common forms
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
Lollipop-like aleurioconidia
Multinucleated giant cell with yeasts
GMS stain of yeasts
PAS stain of yeasts
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Skin rash
Erythema migrans
Various rash presentations
Erythema migrans lesions
Late stage: osteoarthritis
Adult deer tick
Normal and engorged
Contributed by Bobbi Pritt, M.D.
Giemsa stained thin blood films from patient in northwest North America with recurrent fevers: Borrelia, relapsing fever group (not Lyme disease causing Borrelia species), probably Borrelia hermsii
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Perivascular lymphocytic infiltrate
Darkfield microscopy
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Candida auris pneumonia
Candida auris encephalitis
Contributed by Amaro Nunes Duarte-Neto, M.D., Ph.D.
Candida auris and inflammatory cells
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Culture and microscopic images of C. auris
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Candida albicans chlamydospore
Yeast cells ultrastructure
Contributed by Bobbi Pritt, M.D.
Bed bugs
Bed bugs: Cimex lectularius
Bed bugs: Cimex lectularius
Bed bug: setae shorter than width of eye
Bat / bird bed bug: prominent long setae
Contributed by Joshua A. Lieberman, M.D, Ph.D.
C. perfringens
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Fluorescence under UV light
Contributed by Joshua A. Lieberman, M.D, Ph.D.
C. perfringens
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Spores
Contributed by Hasan Samra, M.D.
Clostridium perfringens isolated in culture
Contributed by Hasan Samra, M.D.
Clostridium spp.
Clostridium perfringens - an osmosis preview
Contributed by Bobbi Pritt, M.D. and Institute of Tropical Medicine Antwerp
Cordylobia rodhaini: third instar larva
C. rodhaini and
C. anthropophaga
- Below is a partial list of commercially available SARS-CoV-2 assays in the U.S. and a comparison of the key features based on manufacturers’ claims gleaned from package inserts and news releases (FDA: Emergency Use Authorizations - In Vitro Diagnostics EUAs [Accessed 24 April 2020])
- Independent studies are needed to verify the comparative performances of these assays; due to the rapid rollout of these emergency use authorization assays, peer reviewed publications will take time to catch up
- The analytical sensitivities (limits of detection) vary widely among assays
Table 1. Performance Characteristics of Some EUA SARS-CoV-2 Assays
| Manufacturer | In Vitro Diagnostic EUAs | Technology | Claimed LoD | Sensitivity | Specificity |
| Abbott | Abbott RealTime SARS-CoV-2 Assay | rRT-PCR | 100 copies/mL | 100% at 1-2x LoD | 100% |
| Abbott | ID NOW COVID-19 Test | Isothermal nucleic acid amplification | 125 copies/mL | 100% at 2-5x LoD | 100% |
| Becton Dickonson | BD SARS-CoV-2 Reagents | rRT-PCR | 40 copies/mL | 95% at 1-2x LoD, 100% at 3-5x LoD | 100% |
| Becton Dickonson | BioGX SARS-CoV-2 Reagents | rRT-PCR | 40 copies/mL | 95% at 1-2x LoD, 100% at 3-5x LoD | 100% |
| BGI Genomics | Real-Time Fluorescent RT-PCR Kit for Detecting SARS-2019-nCoV | rRT-PCR | Throat: 150 copies/mL; BALF: 100 copies/mL | Throat: 95% at 1x LoD; BALF: 100% at 1x LoD | 100% |
| *Bio-Rad | Platelia SARS-CoV-2 Total Ab assay | ELISA (IgM, IgA, IgG) | 100% serum (n=27), 83% plasma (n=24) | 99.6% | |
| BioFire | BioFire COVID-19 Test | rRT-PCR | 330 copies/mL | 100% at 1x LoD | 100% |
| *Cellex | qSARS-CoV-2 IgG/IgM Rapid Test | Lateral flow immunoassay (IgM, IgG) | 94% (n=128, no symptoms to severe) | 95.6% | |
| Cepheid | Xpert Xpress SARS-CoV-2 | rRT-PCR | 250 copies/mL | 100% at 2x LoD | 100% |
| Co-Diagnostics | Logix Smart Coronavirus Disease 2019 (COVID-19) Kit | rRT-PCR | 4290 copies/mL of sputum | 100% at 1x LoD | 100% |
| DiaCarta | QuantiVirus SARS-CoV-2 Test Kit | rRT-PCR | ABI QuantStudio 5: 200 copies/mL; ABI 7500 Fast Dx: 100 copies/mL | ABI QuantStudio: 95% at 1x LoD; ABI 7500 Fast Dx: 100% at 1x LoD | 100% |
| DiaSorin | Simplexa COVID-19 Direct Assay | rRT-PCR | 500 copies/mL | 100% at 1x LoD | 100% |
| GenMark | ePlex SARS-CoV-2 Test | RT-PCR, electrochemical detection | 1 x 105 copies/mL | 94.4% at 1x LoD | 100% |
| Gnomegen | Gnomegen COVID-19 RT-Digital PCR Detection Kit | rRT-PCR, digital, nanofluidic chip | 60 copies/mL | 100% at 1-2x LoD | 100% |
| Hologic | Panther Fusion SARS-CoV-2 Assay | rRT-PCR | 0.01 TCID50/mL | 100% at 1-5x LoD | 100% |
| InBios | Smart Detect SARS-CoV-2 rRT-PCR Kit | rRT-PCR | 7500 Fast Dx: 1100 copies/mL; CFX96 Touch: 860 copies/mL | 100% at 1x LoD | 100% |
| Ipsum | COV-19 IDx Assay | rRT-PCR | 8.5 x 103 copies/mL | 100% at 1x LoD | 100% |
| Luminex | NxTAG CoV Extended Panel Assay | rRT-PCR | 5.0 x 103 copies/mL | 95% at 2x LoD | 100% |
| Luminex | ARIES SARS-CoV-2 Assay | rRT-PCR | 7.5 x 104 copies/mL | 100% at 1x LoD | 100% |
| Mesa Biotech | Accula SARS-CoV-2 | rRT-PCR, lateral flow | 200 copies/60uL reaction (pooled nasal & throat) | 100% at 2-50x LoD | 100% |
| NeuMoDx | NeuMoDx SARS-CoV-2 Assay | rRT-PCR | 150 copies/mL | 100% at 1.5x LoD | 100% |
| *Ortho | Vitros Anti-SARS-CoV-2 Total Reagent Pack and Total Calibrator | Immunometric luminescent reaction (IgG) | 92.3% at 1-5 days, 88.9% at 6-15 days, 75% at 16-22 days post-PCR | 100% | |
| PerkinElmer | PerkinElmer New Coronavirus Nucleic Acid Detection Kit | rRT-PCR | ORF1ab: 8.3 copies/mL; N: 27.2 copies/mL | ORF1ab: 100% at 1.5x LoD; N: 100% at 1.5x LoD | 100% |
| Primerdesign | Primerdesign Ltd COVID-19 genesig Real-Time PCR assay | rRT-PCR | 330 copies/mL | 94.7% at 1-2x LoD, 100% at 3-5x LoD | 100% |
| QIAGEN | QIAstat-Dx Respiratory SARS-CoV-2 Panel (22 bacterial & viruses) | rRT-PCR | 500 copies/mL | 100% at 1-2x LoD | 100% |
| Quidel | Lyra SARS-CoV-2 Assay | rRT-PCR | 800 copies/mL | 100% at 1x LoD | 100% |
| Roche | cobas SARS-CoV-2 Assay | rRT-PCR | 0.007 TCID50/mL | 100% at 1.5x LoD | 100% |
| *Roche | Elecsys Anti-SARS-CoV-2 | Sandwich immunoassay (antibodies) | 65.5% at ≤ 6 days, 88.1% at 7-13 days, 100% ≥ 14 days post-PCR | 99.8% | |
| Thermo Fisher | TaqPath COVID-19 Combo Kit | rRT-PCR | 10 copies/140uL | 100% at 1x LoD | 100% |
Abbreviations: LoD = limit of detection; rRT-PCR = real time reverse transcriptase polymerase chain reaction
Table 2. Categories of SARS-CoV-2 EUA Assays and Examples
| Category | In Vitro Diagnostic EUAs | Instruments | Throughput | Cycle Time |
| Point of Care Setting | ||||
| Abbott ID NOW COVID-19 Test | ID NOW | Nonbatch | 5 min (+), 13 min (-) | |
| Cepheid Xpert Xpress SARS-CoV-2 | GeneXpert Xpress System | Nonbatch modular | 45 min per cartridge | |
| Mesa Biotech Accula SARS-CoV-2 | Accula/Silaris Dock | Nonbatch cassette | 30 min | |
| Respiratory Pathogen Panel | ||||
| Qiagen QIAstat-Dx Respiratory SARS-CoV-2 Panel (22 bacterial & viruses) | QIAstat Dx Analyzer System | Nonbatch modular | About 1 hour per cartridge | |
| Serology | ||||
| Bio-Rad Platelia SARS-CoV-2 Total Ab | None | 96 wells per microplate (manual) | 1st incubation: 60 min 2nd incubation: 30 min | |
| Cellex qSARS-CoV-2 IgG/IgM Rapid Test | None | Nonbatch cassette | 15-20 min per cassette | |
| Ortho VITROS Immunodiagnostic Anti-SARS-CoV-2 Total Reagent and Calibrator | VITROS Eci/EDiQ/3600 or VITROS 5600/XT 7600 | Automated | 37 min incubation plus 48 min testing | |
| Roche Elecsys Anti-SARS-CoV-2 | cobas e411, e601, e602, e801 | Automated | 18 min | |
| Modular Cartridge / Cassette / Pouch | ||||
| BioFire COVID-19 Test | FilmArray 2.0 or Torch | Nonbatch modular | 50 min per pouch | |
| Cepheid Xpert Xpress SARS-CoV-2 | GeneXpert Dx / Infinity | Nonbatch modular | 45 min per cartridge | |
| GenMark ePlex SARS-CoV-2 Test | ePlex | Nonbatch modular | cartridge | |
| Luminex ARIES SARS-CoV-2 Assay | ARIES System | Nonbatch cassette | 2 hours per cassette | |
| Qiagen QIAstat-Dx Respiratory SARS-CoV-2 Panel (22 bacterial & viruses) | QIAstat Dx Analyzer System | Nonbatch modular | About 1 hour per cartridge | |
| High Throughput Capability | ||||
| Abbott RealTime SARS-CoV-2 Assay | m2000 RealTime | 96 wells per batch | ||
| BGI Real-Time Fluorescent RT-PCR Kit for Detecting SARS-2019-nCoV | ABI 7500 Real Time PCR | 96 wells per batch | ||
| DiaCarta QuantiVirus SARS-CoV-2 Test Kit | ABI QuantStudio 5 / 7500 Fast Dx Real-Time PCR | Batch | ||
| DiaSorin Simplexa COVID-19 Direct Assay | LIAISON MDX | Batch | ||
| Hologic Panther Fusion SARS-CoV-2 Assay | Panther Fusion | 1150 samples per 24 hours | < 3 hours | |
| InBios Smart Detect SARS-CoV-2 rRT-PCR Kit | ABI 7500 Fast Dx Real-Time PCR / CFX96 Touch Real-Time PCR | 96 wells per batch | ||
| Luminex NxTAG CoV Extended Panel Assay | Luminex MAGPIX & bioMerieux easyMAG / EMAG | 96 wells per batch | < 2.5 hours thermal cycler run time | |
| NeuMoDx SARS-CoV-2 Assay | NeuMoDx 96 and 288 Molecular Systems | Random access, modular | ||
| Ortho VITROS Immunodiagnostic Anti-SARS-CoV-2 Total Reagent and Calibrator | VITROS Eci/EDiQ/3600 or VITROS 5600/XT 7600 | 100 wells per reagent pack | 37 min incubation plus 48 min testing | |
| PerkinElmer New Coronavirus Nucleic Acid Detection Kit | ABI 7500 Real-Time PCR | 96 wells per batch | ||
| Primerdesign Ltd COVID-19 genesig Real-Time PCR Assay | ABI 7500 / Bio-Rad CFX Connect / Roche LightCycler 4800 II | Batch | ||
| Quidel Lyra SARS-CoV-2 Assay | ABI 7500 Fast Dx/Standard, Roche LightCycler 480, Qiagen Rotor-Gene Q, BioRad CFX96 Touch, Thermofisher Quantstudio 7 Pro | Batch | ||
| Roche cobas SARS-CoV-2 Assay | cobas 6800/8800 | 384/960 per 8 hours | 3.5 hours | |
| Thermal Fisher TaqPath COVID-19 Combo Kit | Applied Biosystems 7500 Fast Dx | 96 wells per batch | 4 hours (incl. sample prep) | |
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
Characteristic colony formation of Cryptococcus sp.
Contributed by Sixto M. Leal, Jr., M.D., Ph.D. and @zaalruwai83 on Twitter
Cryptococcus sp. on staining
Characteristic morphology of Cryptococcus with various stains
Cryptococcus neoformans & C. gattii
Contributed by Meredith Schade, M.D. and Elizabeth Garrett, Ph.D.
Shoulder PJI
Colony morphology
Contributed by Elizabeth Garrett, Ph.D.
C. acnes Gram stain
C. acnes in tissue
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Life cycle
Contributed by Bobbi Pritt, M.D.
Cyclospora cayetanensis oocysts stained by Wright-Giemsa
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Various images
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
Dermatiaceous (black) mold
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
Characteristic fruiting bodies
Evaluation of fungal elements with various stains
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Typical rash of dengue fever
Aedes aegypti
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Hemophagocytosis
Stars indicate erythrocytes phagocytized by a macrophage
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Dengue virus virions
Contributed by Bobbi Pritt, M.D. and Tara Ness, M.D.
Likely
Dermatophagoides
Dermatophagoides
versus
Sarcoptes scabiei
Creepy Dreadful Wonderful Parasites Case
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Life cycle - Diphyllobothrium latum
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Proglottids
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Eggs in wet mount
Proglottids and scolex
Adults and eggs in tissue
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Life cycle
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Adult tapeworm
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Eggs, various images
Proglottids
Cross sections
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Life cycle of D. repens
Contributed by Bobbi Pritt, M.D.
10 cm long D. repens removed from conjunctiva
Contributed by Bobbi Pritt, M.D.
470 μm in diameter
Dirofilaria has longitudinal cuticular ridges
Loa loa has irregularly spaced cuticular bosses
Contributed by Bone Moe Win, M.B.B.S.
"Third testes" in infant
Contributed by Bobbi Pritt, M.D.
Knott concentration performed on blood revealed 6 larvae per mm, each ~375 μm long by ~10 μm wide
D. repens versus L. loa
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Left: HGA (HGE)
Rhodamine labeled HGE organisms
HGE antigens
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HME
Intracytoplasmic inclusion
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Dense core cells of E. chaffeensis
Several morulae
Bone marrow white blood cell
Contributed by Bobbi Pritt, M.D., Blaine Mathison and Henry Bishop
Trichrome stained stool specimen shows Enteromonas hominis trophozoites
Diagnostic features
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Life cycle
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Adult liver fluke
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Egg with unshouldered operculum
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Life cycle of filarial worms
Diagnostic features
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Unusual
groupings of
benign appearing
calcifications
Noncalcified opacities (left); calcified worms (right)
Linear, tortuous,
noncalcified
opacities
Oval shaped isodense lesion (arrow)
Cyst with few linear echogenic foci (arrow)
Dilated tubular
channels; filarial
worm (white arrows)
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Right breast lump with pigmentation
Lump in the right breast
Resolved infection after DEC therapy
Contributed by Bobbi Pritt, M.D. and AFIP images
Adult female worm
Gravid female worm of
Wucheria bancrofti
surrounded by fibrosis
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Wuchereria bancrofti
Microfilaria
"Filarial dance"
BMJ Case Rep 2019;12:e229956
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Lemierre syndrome pathophysiology
Clinical characteristics of Lemierre syndrome
Contributed by Hasan Samra, M.D.
Culture media
Contributed by Hasan Samra, M.D.
Gram stain
Contributed by Megan Amerson-Brown, M.L.S., Ph.D. and Julia Hankins, Ph.D.
H. influenzae on chocolate agar
Haemophilus ID quad plate
H. infuenzae in a BAL culture
Sinus culture growing H. influenzae
Contributed by Megan Amerson-Brown, M.L.S., Ph.D.
H. influenzae Gram stain
BAL direct Gram stain
Sinus wash direct Gram stain
Gram stain from CSF culture
Contributed by Megan Amerson-Brown, M.L.S., Ph.D.
H. influenzae in blood culture
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
Uniform clustered yeasts
Uniform clustered yeasts within histiocytes
Lollipop aleurioconidia of Histoplasma
Tuberculate macroconidia
Bone marrow with clustered yeasts
GMS showing clustered yeasts
Necrotizing granulomas
GMS small uniform single and clustered yeasts
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Global distribution of human hookworm infection
Hookworm life cycle
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Edema from heavy hookworm infection
Adult A. caninum hookworms in canine small intestine
Contributed by Bobbi S. Pritt, M.D., M.Sc.
Female and male Ancycloctoma duodenale
Contributed by Bobbi S. Pritt, M.D., M.Sc.
Multiple spicules of male Ancycloctoma duodenale
Buccal canal comparison, hookworm and Strongyloides
Hookworm egg with thin, colorless shell
Cutting plates of N. americanus
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
Broad septate hyphae
Septate hyphae on GMS
Hyphae with fruiting bodies
Septate hyphae
Fruiting bodies of A. fumigatus
Fruiting bodies of A. terreus
Fruiting bodies of A. flavus
Fruiting bodies of A. niger
Macroconidia of Fusarium spp.
Spore forming anelloconidia
Fruiting bodies of Penicllium spp.
Fruiting bodies of Paecilomyces spp.
Fruiting bodies on GMS
Contributed by Bobbi Pritt, M.D. and Institute of Tropical Medicine Antwerp
H. diminuta egg
H. nana and H. diminuta eggs
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Life cycle: Hymenolepis nana
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Large number of adult worms in colon
Adults
Contributed by Bobbi Pritt, M.D.
H. nana egg in stool specimen
H. nana and H. diminuta eggs
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Morphological characteristics
Eggs, various images
Proglottids, various images
Adults
Contributed by Bobbi Pritt, M.D.
Anal Pap smear
Case #402
Anal Pap smear
Contributed by Joshua A. Lieberman, M.D, Ph.D.
K. pneumoniae,
K. oxytoca and
β hemolytic Streptococcus
K. oxytoca on a blood agar plate
Contributed by Joshua A. Lieberman, M.D, Ph.D.
Gram stain of
K. oxytoca
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Life cycle of Legionella pneumophila
Contributed by Elizabeth M. Garrett, Ph.D.
Legionella pneumophila on agar
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Lung pathology
Contributed by Elizabeth M. Garrett, Ph.D.
Legionella pneumophila Gram stain
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Silver stain, lung tissue
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Legionella pneumophila
Contributed by Joshua A. Lieberman, M.D, Ph.D.
Skin lesion
Contributed by Joshua A. Lieberman, M.D, Ph.D.
Nasal septum
Skin lesion
Giemsa
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Leishmania amastigotes in stained smear
Peripheral blood and bone marrow involvement
Contributed by Amaro Nunes Duarte-Neto, M.D., Ph.D.
Bilateral and diffuse alveolar interstitial pattern
Post tracheal intubation
Contributed by Amaro Nunes Duarte-Neto, M.D., Ph.D.
Severe leptospirosis hepatitis
Severe leptospirosis hepatitis
Severe leptospirosis hepatitis - IHC
Lung in fatal leptospirosis
Brain in fatal yellow fever
Heart in fatal yellow fever
Kidney in fatal yellow fever
Renal lesion in leptospirosis (interstitial nephritis) - IHC
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Septal capillary
Contributed by Elizabeth M. Garrett, Ph.D.
Gram stain
Colonies on blood agar
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Life cycle
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Anterior chamber of eye
Temporal subconjunctival space of eye
Cutaneous infection
Contributed by Bobbi Pritt, M.D.
5 cm long Loa loa extracted from eye
Contributed by Bobbi Pritt, M.D.
Irregularly spaced cuticular bosses
In comparison, Dirofilaria has longitudinal cuticular ridges
Contributed by Blaine A. Mathison, B.S.
Loa loa thick film
Loa loa thin film
Contributed by Bobbi Pritt, M.D.
Knott concentration made and stained with Carazzi to show larvae measuring (on average) 280 μm in length
D. repens versus L. loa
Contributed by Sixto M. Leal Jr., M.D., Ph.D.
SP4 broth for culture of lab adapted M. genitalium
SP4 agar photo of M. genitalium colonies
Contributed by Sixto M. Leal Jr., M.D., Ph.D.
SP4 broth for culture of lab adapted M. hominis
10B broth for culture of Ureaplasma species
SP4 agar photo of M. hominis colonies
A8 agar photo of Ureaplasma colonies
Contributed by Sixto M. Leal Jr., M.D., Ph.D.
SP4 broth for culture of M. pneumoniae
Representative colony photo of M. pneumoniae
Contributed by Bobbi Pritt, M.D.
15 cm long Macracanthorhynchus worm with pseudosegmented body and retracted proboscis
Contributed by Bobbi Pritt, M.D. and Emily Fernholz
Macracanthorhynchus eggs
Histologic sections of anterior end of Macracanthorhynchus worm
Macracanthorhynchus egg
Contributed by Andrew Handel, M.D.
Penile lesions
Penile shaft lesions
Contributed by Ryan F. Relich, Ph.D.
Virions in lesion
Dumbbell shaped virion
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Jejunal loops and extensive lymphadenopathy (MAI)
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Bright yellow colonies
Swimming pool granuloma
Swollen, red papules and nodules
Ulcer on the lateral surface of the fifth toe
Contributed by Chaohui L. Zhao, M.D. and Vicente Nazareno
Granulomatous inflammation
Pink slender rods
Pink-red slender rods
Yellow-green fluorescent rods
Quick revision of nontuberculous mycobacteria with mnemonics
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Botfly & blowfly life cycles
Contributed by Bobbi Pritt, M.D. and Lars Westblade, Ph.D.
Furuncular myiasis
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Cutaneous (furuncular) myiasis
Ocular myiasis following trauma
Myiasis of breast carcinoma
Maggots in the mandible
Breast myiasis, tumbu fly larvae
Sinuses after larva extraction
Healed skin after 1 week
Contributed by Bobbi Pritt, M.D.
D. hominis, third instar
D. hominis, spineless terminal segments
D. hominis, pear shaped body
C. macellaria,
posterior spiracles;
prominent slit-walls
C. anthropophaga,
posterior spiracles;
sinuous slits
C. rodhaini, posterior spiracles; irregular slits
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C. hominivorax
versus D. hominis
distinguishing
features
Larva of D. hominis
Larva of C. hominivorax
Contributed by Nada Mohamed, M.D., Bobbi Pritt, M.D. and Lars Westblade, Ph.D.
Cutaneous (furuncular) myiasis
Larval / maggot cross section
Skin biopsy with fly larva
Larval structures
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Dermatobia identification using ITS2
Dermatobia identification using COX1
Cutaneous myiasis
Creepy Dreadful Wonderful Parasites Case
Contributed by Elizabeth M. Garrett, Ph.D.
Colonies on blood agar
Contributed by Elizabeth M. Garrett, Ph.D.
Gram negative diplococci
Contributed by Sixto M. Leal Jr., M.D., Ph.D.
N. asteroides colonies,
chocolate and sheep
blood agar
Contributed by Sixto M. Leal Jr., M.D., Ph.D.
Filamentous branching
Filamentous branching on GMS stain
Skin nodule with Nocardia growth
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Firm, erythematous papule of the right thumb
Hand infection
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Rare necrotic keratinocytes
Balloon degeneration and spongiosis
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Oval viral particles
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Life cycle of Pediculus humanus capitis
Contributed by Bobbi Pritt, M.D.
Male Pediculus humanus
P. h. capitis
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Fever paroxysm
Life cycle
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Adult of Anopheles freeborni
Contributed by Bobbi Pritt, M.D.
P. falciparum malaria, > 10% parasitemia, negative rapid antigen, Giemsa stained thin blood smear
Giemsa stained thick and thin peripheral blood films from a patient with malaria due to P. falciparum; > 20% parasitemia
Contributed by Patricia Tsang, M.D., M.B.A.
Plasmodium falciparum (blood smear)
Case #277
Blood smear
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Ring form trophozoites of P. falciparum
Maurer clefts
Older trophozoites of P. falciparum
Gametocytes of P. falciparum
Schizonts of P. falciparum
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Fever paroxysm
Life cycle
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Adult of Anopheles freeborni
Contributed by Monica E. De Baca, M.D. and Bobbi Pritt, M.D.
Immature trophozoite (ring) forms, P. vivax
Immature trophozoite (ring) forms, P. vivax
Gametocyte forms, P. vivax
Gametocyte forms, P. vivax
Gametocyte forms, P. vivax
Gametocyte forms, P. vivax
Gametocyte forms, P. vivax
Schizont forms, P. vivax
Schizont forms, P. vivax
Schizont forms, P. vivax
Malaria parasites in human red blood cells, P. malariae
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Giemsa, P. ovale
Wright-Giemsa, P. ovale
P. ovale gametocyte in a thick blood smear
Microgametocyte of P. ovale in a thin blood smear
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Egg of Raillietina
Contributed by Bobbi Pritt, M.D.
Motile, rice-like object in stool of toddler
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Raillietina tetragona
Contributed by Bobbi Pritt, M.D.
Egg capsules containing eggs
Eggs with hooklets
Contributed by Bobbi Pritt, M.D. and Institute of Tropical Medicine Antwerp
Intestinal sarcocystosis: sporulated oocyst and sporocyst
Carbolfuchsin staining according to Heine
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Life cycle
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Contributed by Kiran Alam, M.B.B.S., M.D., Anshu Jain, M.B.B.S., M.D., Veena Maheshwari, M.B.B.S., M.D., Farhan A. Siddiqui, M.B.B.S., M.D. and Ershad ul Haq, M.B.B.S., M.D.
Transitional
epithelium of
ureter with S.
haematobium eggs
Schistosome eggs in submucosa
Schistosome eggs in muscle layer
Schistosome eggs in muscle layer - note terminal spine
Contributed by Jennifer Stumph, M.D.
37 year old woman with S. mansoni eggs in colon biopsy
Contributed by Lisa Cerilli, M.D.
With colonic mucosa - type not identified
Contributed by Bobbi Pritt, M.D. and Heather Rose
Schistosoma haematobium eggs and uric acid crystals
Contributed by Bobbi Pritt, M.D. and Sarah Jung, M.D.
Schistosoma haematobium miracidium, newly hatched with egg remnant
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Subspecies
Granuloma surrounding egg - type not identified
Schistosoma haematobium - oval eggs with terminal spine:
Schistosoma haematobium eggs
Schistosoma japonicum - small eggs,
more rounded, no / minute terminal spine:
Eggs
Schistosoma mansoni - lateral spine:
Schistosoma mansoni eggs
Contributed by Megan Amerson-Brown, M.L.S., Ph.D. and Sixto M. Leal, Jr., M.D., Ph.D.
Nonpigmented S. marcescens colonies
Pigmented colonies of S. marcescens
Contributed by Megan Amerson-Brown, M.L.S., Ph.D.
S. marcescens direct Gram stain
S. marcescens Gram stain from colonies
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Histopathology of Shigella colitis
Gross pathology of shigellosis
Contributed by Nicole E. Putnam, Ph.D.
Shigella on SBA
Shigella on MAC
Shigella on Hektoen
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Ulcerative colitis by colonoscopy
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Colonies of Staph. aureus
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Gram positive cocci in clusters
Contributed by Joshua A. Lieberman, M.D., Ph.D.
Chocolate agar
Contributed by Joshua A. Lieberman, M.D., Ph.D.
Gram stain
Contributed by Ashleigh N. Riegler, Ph.D.
Dimpled S. pneumoniae colonies
Mucoid S. pneumoniae colonies
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
S. pneumoniae in blood
S. pneumoniae in CSF
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Various Strep group colonies
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Life cycle
Contributed by Bobbi Pritt, M.D.
Adult female and larvae
Prominent genital primordium
Case #133
Duodenal biopsies of a 43 year old Honduran man
Contributed by Bobbi Pritt, M.D.
Endodoscopy of elderly woman with hematemesis (parasite case #499)
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Life cycle
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Gravid uterus of T. saginata with > 13 lateral branches
Contributed by Wikipedia
Taenia solium adult
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Life cycle
Contributed by Centers for Disease Control and Prevention
MRI
Contributed by Centers for Disease Control and Prevention and Wikipedia
Brain tissue
Cysticercus
T. solium scolex
Egg of T. solium
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Taenia solium life cycle
Contributed by Victor H. Ramos-Pacheco, M.D.
CT scan
Contributed by Laura G. Chávez-Macías, M.D., Erick Gómez Apo, M.D., Ph.D., Mario T. Espinosa-Romero, M.D. and Aurea Escobar-España, M.D.
Fourth ventricle cyst
Extraparenchymal neurocysticercosis
Basal organized exudate
Subarachnoid pontine cysticercus
Cysticercal cysts
Resected cysticerci
Contributed by Laura G. Chávez-Macías, M.D., Erick Gómez Apo, M.D., Ph.D., Aurea Escobar-España, M.D. and Mario T. Espinosa-Romero, M.D.
Cysticercus
Cysticercus hooklet
Cysticercus wall
Tegument
Microvilli
Chronic granulomatous inflammation
Calcareous bodies
Scolex
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Life cycle
Contributed by Bobbi Pritt, M.D.
Taenia species eggs
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Penicillium (A / C)
vs. Histoplasma
capsulatum (B / D)
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Skin lesion at bite site
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Various images
Dorsal image of male
Ventral image of male
Contributed by Bobbi Pritt, M.D.
Female Ixodes tick
Contributed by Bobbi Pritt, M.D.
T. cati worms
Contributed by Bobbi Pritt, M.D.
T. cati egg
Pollen grain and Toxocara egg
Contributed by Bobbi Pritt, M.D.
Trichostrongylus egg
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Trichostrongylus egg
Trichostrongylus egg
Contributed by Bobbi Pritt, M.D.
Colon at autopsy
shows small
worm-like objects
attached to mucosa
Eggs with polar plugs
Contributed by Bobbi Pritt, M.D. and Heather Rose Arguello
Posterior and anterior end of whipworm
Multiple stichocytes
Immature ova in uterus in posterior end
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Ultrasound showing hepatic steatosis
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Steatotic liver in YF
Yellowish color due to diffuse steatosis
Contributed by Amaro Nunes Duarte-Neto, M.D., Ph.D.
Severe yellow fever hepatitis
Characteristic distribution of damage in YF hepatitis
Apoptosis in yellow fever hepatitis
Centrilobular area in yellow fever hepatitis
Hallmark diagnostic findings for YF hepatitis
Portal tract in yellow fever hepatitis
Distribution of YFV antigens in yellow fever hepatitis
Diagnostic immuno-histochemistry in YF hepatitis
Renal damage in yellow fever
Lung in fatal yellow fever
Brain in fatal yellow fever
Contributed by Sixto M. Leal, Jr., M.D., Ph.D.
Mucor species
Mucor species fungal elements
Fungal forms
Mucor species angioinvasion
Barer: 2018
Bogitsh: 2018
Carter: 2017
Flint: 2020
Ghosh: 2017
Gunn: 2022
Hewlett: 2021
Kawilarang: 2019
Kawilarang: 2019
Kawilarang: 2019
Kawilarang: 2019
Kawilarang: 2019
Kawilarang: 2019
Kawilarang: 2019
Kawilarang: 2019
Leventhal: 2019
Levinson: 2018
Love: 2018
Mahon: 2023
McPherson: 2021
Mertz: 2018
Nabarro: 2019
Pritt: 2018
Procop: 2020
Ryan: 2021
Sastry: 2018
Schmitt: 2017
Tille: 2021
Westblade: 2023
Wright: 2018
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