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Case of the Week 56

The following was ‘passed’ in the stool of an otherwise asymptomatic 50 year old woman. (images courtesy of Dr. Washington Winn, Fletcher Allen Health Care, VT)

Identification?

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diphyllobothrium latum

diphyllobothrium latum and the differential diagnosis Taenia sp

The picture is of a worm belonging to the class cestode, it is a Diphyllobothrium latum; cause the proglottids are wider than they are long, the scolex which is not provided in a high power picture will has no hooks (unlike other taenia sp.) but 2 elongating sucking grooves.
This type of worms usually doesn’t cause harm to the patient, but as in one of House series a young patient present with subacute combined degeneration of the cord and megaloblastic anemia that doesn’t respond to the multivitamin complex administration cause this worm consume all of it, this can be true if it had been administrated orally but not parentally as House trying to fool us.

tape worm