Monday, December 4, 2017

Case of the Week 471

Welcome to the first case of the month featuring a case from Idzi Potters at the Institute of Tropical Medicine Antwerp. This case is really spectacular and something we don't see very often.

The following parasites were discovered in a man's peritoneal tissue during an inguinoscrotal hernia repair.  The resided in Benin, Africa. Here is the resected section of peritoneum along with the attached parasites (CLICK ON IMAGE TO ENLARGE):
 
Diagnosis?

9 comments:

Anonymous said...

Armillifer armillatus

ali mokbel said...

Hmm...A challenging case...as requested :)
It seems like a case of visceral pentastomiasis caused by Armillifer armillatus . However, it would have been helpful if we had some info about the patient's demographics because such parasites usually infest people/domestic animals who come in contact with snake excretions.

Idzi P. said...

A very keen remark, Ali!
The patient was indeed from an African country where snake consumption is rather common.

Anonymous said...

This is an alien worm for me. Thanks folks for pointing me in the right direction, though snake eating both venomous and non venomous is considered a delicacy in my native country (the most delicious they said are the cobras).
This worm suggest the gruesome pictures of victims being invaded by some alien life forms in sci-fi movies.
Idzi: C'est spectaculaire et impressionant.

Florida Fan

Adolfo ID said...

Pentastomiasis

William Sears said...

Pentastomiasis. Likely armillifer sp but per my reading Raillietiella sp is also possible.

Idzi P. said...

Indeed William, Raillietiella cannot be excluded! Especially with the little info given here.
However, most facts speak in strong favor of Armillifer. After some research, I found out that many of the Raillietiella spp. endemic in African countries where snake consumption is common (and lizard consumption is less frequent), like R. boulengeri, R. schoutedeni, R. congolensis, etc., produce smaller nymphs (usually just a few mm) and have more body annuli (ranging from about 25 to about 40).
J.H. Ali has been researching Raillietiella a lot during 1981-1985; also A. Fain’s publication of 1961 (Les pentastomides de l’Afrique Centrale) is very interesting on this subject!
Still, I have to admit that the evidence stays circumstantial and that Raillietiella could remain a possibility.
:-)

Nate said...

Gross! (And awesome!)

Anonymous said...

Excellent! I have coincidentally been doing a lot of reading about pentastomes in the past week, and pulling old slide-mounted specimens to try and learn how to recognize them in tissue sections.

The three species I've found in our collection (so far) are Armillifer armillatus, Linguatula serrata and Porocephalus crotali, but I've not seen each of them as intact organisms yet. I believe that Armillifer has the most pronounced pseudo-segmentation in this grub-like stage, so that's what I'll go with.

- Mark Fox