Reference no: EM132738150

Over a 3-month period a 45yo male has explosive, loose stools; abdominal distension; and weight loss. His illness began with an episode of traveler's diarrhea while he was on an extended business trip to Belarus, Poland, and Russia. Initially, he had 5-6 loose stools daily. Now he has fewer bowel movements, but they are fragmented, greasy, and foul smelling. The patient also complains of persistent flatulence and belching with a peculiar "sulfurous" taste. He was seen by two other physicians since the outset of this illness. Routine blood tests, stool cultures, stools for occult blood, and three stool ova and parasite exams (with acid-fast stains) were all negative. The patient was given a course of metronidazole, which seemed to improve his symptoms for about 10 days before they recurred. One physical exam the patient has mild tenderness in the epigastric area. Before resorting again to empiric therapy, which diagnostic test could give you the most information?

a. Entamoeba histolytica antibody
b. Duodenal aspirate and exam
c. Right upper quadrant ultrasound
d. Stool immunoassay for Cryptosporidium antigen
e. Colonoscopy

2. Ascaris infections are most likely to produce eosinophilia at which point in the parasite's life cycle?

a. During the intestinal phase of infection
b. After hatching eggs in the stomach
c. During pulmonary migration
d. During egg production by female worms