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)


(1000x original magnification, Giemsa)



Diagnosis?
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6 comments:

  1. AnonymousFebruary 13, 2012 at 4:30 AM

    could it be Trypanosoma cruzi

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  2. AnonymousFebruary 13, 2012 at 9:11 AM

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

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  3. KathyFebruary 13, 2012 at 10:54 AM

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

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  4. Lukus RobertsFebruary 13, 2012 at 11:01 AM

    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 ...

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  5. AnonymousFebruary 13, 2012 at 10:30 PM

    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

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  6. AnonymousFebruary 14, 2012 at 4:47 AM

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

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