Sunday, February 12, 2012

Case of the Week 195

A 30 yo man with travel to South America presented with chronic non-healing warty skin lesions. Repeated skin biopsies were negative for microorganisms by histopathology but culture using brain-heart infusion media with rabbit blood grew the following on day 12 of incubation at 25C.

(1000x original magnification)
video

(1000x original magnification, Giemsa)



Diagnosis?

6 comments:

Anonymous said...

could it be Trypanosoma cruzi

Anonymous said...

Leishmania promastigotes; the amastigote is seen in tissue, but they convert in culture to promastigotes.

Kathy said...

With "chronic non-healing warty skin lesions" I would say Leishmania sp.

Lukus Roberts said...

Leishmania - at first I thought the skin lesions could be a reation to the bite of Reduviid bugs and thus, that it could be T. cruzi, but if the lesions are chronic, then I agree with the others above and say that these are Leishmania promastigotes ...

Anonymous said...

Gotta be cutaneous Leishmaniasis > New World; speciation to follow! It is really cool that we can perform the cultures in our lab now. Be nice if we can speciate - though likely will need to rely on the CDC Leishmania for that. Very Cool! - Mundele Djo

Anonymous said...

the faint big darkpink blob is the nucleus.
The small clear pink dot is the kinetoplast