1. Parasitology department
Interactive session IV

2. Group task I Problem solving : Case study
Students will be Classified into groups
Students of each group will analyze the problem and answer the given questions

3. A 16-month-old child was admitted to the pediatrics department of Ain Shams University hospital. The child presented with a six-day history of abdominal pain , vomiting, and profuse diarrhea. He is a child of dairy farmers.He experienced up to 7 episodes of nonbloody watery diarrhea per day. On initial physical examination, the patient was afebrile. He was moderately dehydrated with very minor signs of dehydration such as weight loss, deep-set eyes.
The patient was placed on intravenous fluids while waiting for laboratory results.
The laboratory work-up revealed normal white blood cell count with normal eosinophil count.

4. Stool specimens were also sent for routine bacterial culture, rotavirus/adenovirus antigen, and all were negative
Routine stool examination for enteric parasites including direct saline wet mount examination and concentration techniques were negative. Modified Ziehl-Nielsen staining of a stool smear showed several parasitic oocysts , rounded, bright red in color against green background as shown in the figure

5. Analyze the case

6. History
O/E
Investigations

7. 2- What are the possible modes of infection ?
1- What is your provisional diagnosis? What are the criteria you based on your diagnosis?
2- What are the possible modes of infection ?
3- What are the other methods for diagnosis?
4-How can you treat this case?
5- What do you suggest as preventive measures?
6-If the patient is a 10 years old child receiving chemotherapy for treatment of leukemia since 2 years ago , with CD4 T cell count 100 / mm3 who came to the out patient clinic complaining of cryptosporidiosis.
What is the expected clinical presentation ? Why?

8. Group task II In group, the students will discuss the required data
Each group will present the results to their peer
What are the other parasitic infection that can be presented with diarrhea ? What are the pathogenesis , mode of infection and diagnosis of each

9. QUIZ
Self assessment