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FOReceived a clip of a highly motile larva, seen during microscopy of a stool sample from a 7 year old child. At this magnification, it is difficult to ascertain if this a hookworm or a Strongyloides larva.
However, my opinion is tilting more towards hookworm. We can see an Ascaris egg in the clip as well and it is not usual to see the two together.
The tail appears pointed. But it’s difficult to visualize the buccal cavity.
For determining hookworm from Strongyloides in stool, the difference is in the length of the buccal cavity (long for HW, short for Strongy) and the presence of a genital primordium (only present in Strongy). Also hookworm does not typically appear as larvae in stool unless the specimen is held long without fixative.
Strongyloides only has a forked tail when it is filariform. That is rarely ever seen in stool, only in VERY severe disseminated infections (eg respiratory specimens is usually where they may be seen, rarely).
Clip courtesy: @mianzahidsarfraz
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