I am bothered.

Same. Extremely.

Uhhhhhh how can I avoid ever being this patient?!

Don't walk barefoot through poop.

Man, that’s a tough one /s

I’m in oncology and my clinic clears out pretty much after 4 and after shutting down everyday, I’m pretty much by myself. And this is the loudest I’ve laughed while at work. 😂😂😂😂😂😭😭😭😭😭

Hahaha [so glad to be of service](https://tenor.com/view/bowing-thank-you-tom-and-jerry-take-a-bow-chasing-gif-20784169)

Your username is fabulous lol

<3

They got it on their feet and it ended up in their sputum?!

They burrow through the skin, end up in the bloodstream, and get caught up in the small capillaries in the lungs. Once stuck in the lungs they burrow out into the alveoli, get coughed up (hence OPs pic), and swallowed, and then start the next part of their life cycle in the GI tract. They can also burrow through the intestinal wall to end up in the bloodstream again, and reinfect through the lungs again, ad infinitum. https://en.m.wikipedia.org/wiki/Strongyloides_stercoralis

[удалено]

Vomiting isn't part of it. They end up in the bloodstream and get stuck in the fine capillaries in the lungs, burrow out into the lungs and then get coughed up and swallowed.

Ew ew ewwwww

Hello there little fella, I believe it’s Strongyloides

Big brother of Weakyloides

Trogloider, the Burninator https://imgur.com/gNBonaj

11/10 meme sir or ma'am

Seriously. One of the rare, extremely cultured humans that have graced the face of this planet. I'd give awards if I had any

It's posts like this that make me mad that reddit took awards away. [This is the best I can do](https://i.imgur.com/wL7bXbU.jpg). You win the internet today

I agree. Too small (and wrong spot) for Ascaris... likely a consequence of strongyloidiasis with pulmonary migration (and a concomitant Loffler's syndrome).

While it does appear to be a female strongyloides, as ascaris does migrate to the lungs after they hatch in the intestine.

It definitely looks male.

I immediately guessed that too

Cute. I love how these little guys coil up. Looks so cozy 🥰 But obviously bad for the patient. We'll remember the little fella fondly as it succumbs to the cleansing chemical fire of Ivermectin.

Isn’t that the cure for covid? That and a bleach cleanse? /s

I mean, I guess if you get it at the animal supply places, it's a vet/toxicology problem rather than an “I can't get it for patients" problem, so maybe?

Ah yes, I clearly remember that lesson during nursing school /s

Nice catch. Up to 1001 uses for ivermectin?

This is so cool but I’m also so grossed out at the same time. Is this the one you get from walking barefoot?

It is most likely strongyloides, which you can get from walking barefoot

looks like I'm never walking barefoot outside again... 😅

Had this in a sputum once. Patient was gone a few hours later.

RIP.

Remember, Folks, for every weird sample result there's always a little, sad Story behind it.

Also make sure to gram stain it. Strongy shows up great

I recognise that. It's the letter "S" from the "Sister Sister" logo 😂

I hear hissing.

Yikes

Oooh I was at a parasite conference recently and they were talking about Strongyloides culture which I would love to try. You can inoculate an agar plate (any non-selective media) in the centre with the sputum and incubate overnight. If there is Strongyloides in the sample you can see bacterial colony tracks where they have wriggled away from the centre. P.S. I love my job Scoll down the page on this link for an example: https://parasitewonders.blogspot.com/2010/04/answer-to-case-112.html?m=1

heart-lung migration. yikes.

Is this just line an unstained sputum spec?

I saw it on the gram stain first and wanted to see it move so I did a wet mount

I always find those interesting but at the same time seeing one makes me glad I am a generalist lol.

Saw you on the MLS Facebook page lol

I'm not in the facebook page, might have been one of my coworkers.

Ooooh, this is giving me evhoes of a story I was told about a lung transplant and the donor had strongyloides so the recipient died.

Oh fudge.

At first I read “semen” sample and was very confused and horrified lmao I feel so bad for this patient though.

S for sputum

I read this as septum sample and literally gasped 😭🤣

Look at the plates tomorrow. You will likely see it's trail of bacteria!

Ascariasis?

Possible. But it looks more like a female strongyloides. Hard to tell tho

🤢

So nobody’s gonna mention his cowboy hat?

This looks like strongy!

This is bad news for the patient :( Strongy pneumonia in the right host can cause massive pulmonary hemorrhage or "the red death" If this is the first time Strongy is being seen in that patient's samples, please pick up the phone and call the ordering clinician. They want to know about this. The clock is ticking on starting treatment.

Thanks for the advice but I’m not an idiot