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...


Unknown said...

RBC not enlarged, multiple infections in one cell, some rings are binucleated, no Sch├╝ffner'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