Monday, February 3, 2014

Case of the Week 290

The following were seen on Giemsa-stained peripheral blood films from a 2 year old boy with recent travel to Kenya.  Images are taken at 1000x magnification. Percent parasitemia was 2.7%.

Identification?  What is your differential diagnosis for this morphologic appearance?


Anonymous said...


Tomáš Macháček said...

RBC not enlarged, multiple infections in one cell, some rings are binucleated, no Schüffner's dots, parasites in leukocytes... looks like Pl. falciparum.

Anonymous said...

Agree with the diagnoses above, P. falciparum.

Florida Fan

Anonymous said...

You see more then one stage , the larger cells with malaria pigment look like schizonts to me, which indicate severe disease.
The peripheral bloodstream may be clotted with parasites.
Urgent treatment is needed !

Marco Ligozzi said...

Thin film showing different stages of Plasmodium falciparum. Two normal sized RBCs infected by young trophozoites ( ring form). No Maure's dots. Unusual appearance of a schizont with several nuclei and pigment eccentrically located. P. falciparum schizont are rarely seen in the peripheral blood and their presence may indicate a potentially severe malaria

Marco Ligozzi
Dip patology and diagnostic University of Verona Italy