Stool Microscopy - Parasite DD - Artifacts?

[Beblebud]

Hi everyone! I'm a med student and very new to stool microscopy. I was examining a fresh wet mount / iodine stained sample that was notable for a large amount of undigested muscle fiber. I also observed three structures I couldnt identify yet, perhaps some of you guys can help? Sorry for the bad quality, our microscopes have no cameras attached so I had to use my phone...

Structure 1: A single finding.

Structure 1

IMG_20210202_110813.jpg (76.33 KiB) Viewed 2333 times

Structure 2: Multiple similar objects on the slide

Structure 2

IMG_20210202_112618.jpg (46.36 KiB) Viewed 2333 times

Structure 3: Again, multiple fragments like this one visible.

Structure 3

IMG_20210202_110530_1.jpg (75.99 KiB) Viewed 2333 times

Thank you very much in advance!

[Tom Jones]

So, since you're in med school, what did your lab instructor say they were?

[Beblebud]

Thank you so much for your trust. Since it was a one day rotation from my gastroenterology internship to to diagnostics department at the microbiology department and the very friendly instructor basically left me alone with it - i dont know. I've shown the pictures to the attending gastroenterologist (i hope thats the right word, its called Oberarzt here in Germany) but he had no clue. I can tell you that the patient was not treated for any parasitic infections so far, but i'd still like to know whats on the photograph

[D0c]

I've only googled the last image and it looks very similar to Hymenolepsis nana gravid proglottids

[Tom Jones]

It's been quite awhile since I did any diagnostic parasitology, but I think they were correct in not treating. The fact that you were left alone with the specimen should probably tell you something.

I've no idea what the first two are, but they really don't look like eggs, or anything important to me, so artifacts. The third is probably coiled plant fibers from lunch, and equally unimportant.

[Beblebud]

Thank you. It looks indeed similar to Hymenolepsis, but there were no eggs, so i guess Tom is right.
Anyways, I hope they meant to encourage me to take my time and inspect the sample properly - but since a lot of the staff was in quarantine, the remaining people were a little stressed and it was not really the right atmosphere to ask a lot of questions.

[Tom Jones]

Diagnostic parasitology isn't something you can learn quickly or easily. It takes good training, a lot of time at the microscope, and a whole lot of specimens, positive and negative, to even get adequate, so don't feel bad.