The following thin Giemsa-stained blood smear is from a missionary who just returned from Tanzania. (CLICK ON IMAGES TO ENLARGE)
Identification?
What are the identifying features of this case?
Sunday, August 23, 2009
Saturday, August 22, 2009
Answer to Case 82
Answer: Plasmodium falciparum
The key identifying features are:
1. The infected RBCs are not enlarged (compared to the enlarged RBCs infected by P. ovale and P. vivax.
2. Parasite rings are small and delicate, occupying approximately 1/3 of RBC diameter.
3. Applique or Accole forms are present. These are rings that appear to be 'stuck' onto the edge of the RBC.
4. Presence of Maurer's clefts or dots. These are cytoplasmic structures derived from the malaria parasite. They have a similar appearance to the 'stippling' seen in infection with P. ovale and P. vivax, but the dots are fewer and larger. In order to see Maurer's clefts, it is essential to have your malaria buffer at the proper pH, that is, at 7.2.
Maurer's clefts and stippling are not seen in infection with P. malariae.
The key identifying features are:
1. The infected RBCs are not enlarged (compared to the enlarged RBCs infected by P. ovale and P. vivax.
2. Parasite rings are small and delicate, occupying approximately 1/3 of RBC diameter.
3. Applique or Accole forms are present. These are rings that appear to be 'stuck' onto the edge of the RBC.
4. Presence of Maurer's clefts or dots. These are cytoplasmic structures derived from the malaria parasite. They have a similar appearance to the 'stippling' seen in infection with P. ovale and P. vivax, but the dots are fewer and larger. In order to see Maurer's clefts, it is essential to have your malaria buffer at the proper pH, that is, at 7.2.
Maurer's clefts and stippling are not seen in infection with P. malariae.
Monday, August 10, 2009
Case of the Week 81
Sunday, August 9, 2009
Answer to Case 81
Answer: Probable Strongyloides stercoralis filariform (L3) larvae.
Congratulations to everyone who wrote in with the correct answer! You all recognized that these are nematode (round worm) larvae. The clinical history and presence of larvae in the sputum are most suggestive of S. stercoralis, although it is difficult to make out specific features from these photographs to make a definitive diagnosis. The fact that they are relatively elongated suggests that they are the 3rd stage larvae (L3 or filariform) which is the typical stage that is seen in the lung during autoinfection.
Congratulations to everyone who wrote in with the correct answer! You all recognized that these are nematode (round worm) larvae. The clinical history and presence of larvae in the sputum are most suggestive of S. stercoralis, although it is difficult to make out specific features from these photographs to make a definitive diagnosis. The fact that they are relatively elongated suggests that they are the 3rd stage larvae (L3 or filariform) which is the typical stage that is seen in the lung during autoinfection.
Monday, August 3, 2009
Case of Week 80
Answer to Case 80
Answer: Aedes aegypti mosquito
This is one of the most easily recognizable mosquitoes, due to its dark body and distinctive white markings. It closely resembles another human disease vector, A. albopictus (a.k.a. Asian Tiger mosquito), except that the latter has a single straight white stripe on its dorsal thorax instead of lateral curved stripes.
A. aegypti is the vector of Yellow Fever, Dengue, and Chikungunya virus. The former two viruses may be found in South America, and are the answer to the second question of this case.
This is one of the most easily recognizable mosquitoes, due to its dark body and distinctive white markings. It closely resembles another human disease vector, A. albopictus (a.k.a. Asian Tiger mosquito), except that the latter has a single straight white stripe on its dorsal thorax instead of lateral curved stripes.
A. aegypti is the vector of Yellow Fever, Dengue, and Chikungunya virus. The former two viruses may be found in South America, and are the answer to the second question of this case.
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