Case 29. Heterophyiasis (38 y-o M)
         
   
White and solid material seen in a diarrheal stool
   
         
   
Key words : 
Heterophyes heterophyes, heterophyiasis, Metagonimus yokogawai    
     
 
     
A pear-shaped, 1-2 mm-sized fluke laying eggs is embedded in the inflammatory background (HE, low power).   Note the cuticle, gut, laid eggs, sperms and eosinophilic host reaction (HE, high power). The fluke is bisexual.
     
 
     
Reference case 29A
An egg of Heterophyes heterophyes in feces (24 y-o medical student who stayed in Kenya for 3 months). The small ovum with operculum resembles that of Metagonimus yokogawai. Endoscopic study of the duodenum 3 weeks after stool examination was normal.
  Reference case 29B
Metagonimiasis yokogawai (54 y-o M). Duodenal biopsy reveals a 1 mm-long fluke stuck in the crypt (HE). Note the formation of small-sized ova.