An unusual helminth infection in a South East Asian refugee

Three faecal specimens for parasitic examination from a clinically well threeyear- old South East Asian refugee with a history of eosinophilia, who had previously been treated for a Giardia intestinalis infection, were submitted to the Department of Microbiology and Infectious Diseases of the Royal Hobart Hospital for faecal parasite investigations. No parasites were seen in the formalin-ethyl acetate concentrate of the specimens. A small number of modifi ed acid-fast bodies were observed in the modifi ed iron haematoxylinstained permanent smears. These bodies resembled larvated hookworm eggs, but were much larger and more cylindrical. Some were asymmetrical in shape and others showed some degree of unipolar tapering. Following this fi nding, a new formalin-ethyl acetate concentrate of the patient’s stool was thoroughly re-examined and the eggs were found to be present in very low numbers in this specimen. The eggs were identifi ed as possibly belonging to the trichostrongylid nematode family.