Sunday, August 7, 2011

Case of the Week 171

The following were seen on a peripheral blood thick film from a recent African immigrant. Identification? (CLICK ON IMAGES TO ENLARGE)




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6 comments:

  1. AnonymousAugust 8, 2011 at 8:27 AM

    Any chance of straightening one of these buggars out and placing it next to a micrometer?

    I've narrowed it down, but am also curious about travel history . . .

    Thanks!!!

    ReplyDelete
  2. Lukus RobertsAugust 8, 2011 at 9:41 AM

    As the patient is from Africa , i'm going to rule out Brugia (Asia) and Mansonella (New world). It is obviously not Dirofilaria. Onchocerca does not have a sheath whereas these microfilariae do. Loa loa (featured on the blog recently) do have a sheath but this does not show up when stained.

    therefore, I am going with Wuchereia bancrofti microfilariae, which would have been contracted from the bite of a mosquito - commonly either an Anopheles, Culex, Mansonia or Aedes. Wuchereia is one of the three filarial worm species that can cause lymphatic filariasis which can lead to the condition known as elephatiasis - see here for some of the devastating symptoms that can be produced:

    http://www.google.co.uk/imgres?q=lymphatic+filariasis&um=1&hl=en&sa=N&biw=1920&bih=868&tbm=isch&tbnid=hC3HMHLqXPBsBM:&imgrefurl=http://www.jaskin.com/%253Fp%253D559&docid=12vZqrGSWrjk6M&w=300&h=225&ei=6_Q_To2DHsOw8gOkkInlAg&zoom=1&iact=hc&vpx=1376&vpy=549&dur=1122&hovh=180&hovw=240&tx=128&ty=121&page=1&tbnh=131&tbnw=174&start=0&ndsp=50&ved=1t:429,r:37,s:0

    ReplyDelete
  3. Neuro_NurseAugust 8, 2011 at 9:44 AM

    Geography: somewhere in Africa
    Wuchereria bancrofti, Loa loa, Mansonella perstans, M. streptocerca, Onchocerca volvulus

    Anatomy: blood
    W. bancrofti, L. loa, M. perstans

    Sheathed:
    W. bancrofti, L. loa

    Nuclei do not extend to tail tip:
    W. bancrofti

    ReplyDelete
  4. KathyAugust 9, 2011 at 2:55 PM

    I agree with Neuro_Nurse:
    Wucheria bancrofti

    ReplyDelete
  5. ladybugAugust 13, 2011 at 9:08 AM

    Microfilariae of Wuchereria bancrofti in Geimsa stain.

    ReplyDelete
  6. kristenAugust 15, 2011 at 3:15 AM

    Burgia malayi
    because
    (1)sheathed
    (2)nuclei extend upto tail tip
    (3)nuclei do not form continuous row; two nuclei at tip tail.

    ReplyDelete