Infectious Agents
Case 4

Clinical Features
Electron Microscopy
Discussion

Case 1
Case 2
Case 3
Case 4

Electron Microscopy of Infectious Agents

Case 4: Cryptosporidium in the Bile Duct.

Introduction

Cryptosporidium and Microsporidium have been around for a number of years, but have only recently become a popular diagnostic question as the number of immunocompromised patients has increased. In the Spring of 1993, Cryptosporidium became an overnight media star in Milwaukee after thousands upon thousands of infective spores of this protozoan escaped from our water-treatment facilities and temporarily changed the habits of most of our population for a few days. The news media even filmed McNeil people in flatbed trucks handing out samples of Imodium to large and enthusiastic, albeit somewhat dehydrated, crowds. Ah, the elixir, and what a nice and welcome gesture from the pharmaceutical community. Fortunately, I was out of town that weekend and escaped the exposure. Some were not as fortunate, because serious infections began to show up in some of those who could not fend off the infection, and biopsy specimens began to show up in the EM lab for identification of the organism.

Clinical Features

The case included here is from a bile duct biopsy of a 37 YO man who presented a year after the 1993 outbreak. One micron thick sections stained with toluidine blue showed several areas in which the organisms were clustered, and thin sections were prepared from good target areas.

Electron Microscopy