A nursing assistant enters a radiological procedure room to clean after a procedure was performed on a 39 year-old homeless male veteran. While preparing to clean the room for the next patient he notices a bug crawling down the procedure table. He attempts to catch it but fails and is unable to locate it afterwards. He notifies the charge nurse of what he saw and they both proceed to inspect the room to no avail. Inspecting the table carefully they manage to see what looks like a very small arthropod which they place in a container. The nursing assistant assures the charge nurse that the arthropod he saw was substantially larger then the one in the container. Never-the-less the bug is sent to the laboratory for identification.
Once in the laboratory the arthropod is carefully placed under a dissecting microscope for identification. Below are photographs of the dorsal and ventral aspects of the bug submitted as seen under the dissecting microscope. The ventral aspect is obscured due to the tape that the bug was adhered to when collected by the nursing assistant. As you can see the arthropod is translucent with a slightly visible segmentation of the body present. Mouth parts are intact and appear to function more for piercing. Six legs and prominent eyes are visible as well. The size of the arthropod is approximately 2mm in length.
photo by W. Vientos
photo by W. Vientos
The initial Microbiologist making the identification required some consultation with a more senior/expereinced Microbiologist to make the confirmatory identification. Can you make an identification with what I have provided you with and answer the following questions?
What is the final identification of the arthropod?
What is unusual about this particular arhtropod in terms of size and visual appearence?
Why is it important that the identification be communicated to the radiological head nurse as soon as possible?
What is the clinical significance of this arthropod and its prevalence?
Answers and discussion to follow!