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A parasitologist's view of the world
Welcome to Parasite Case of the Week
Every week I will post a new Case, along with the answer to the previous case. Please feel free to write in with your answers, comments, and questions. Also check out my image archive website at http://parasitewonders.com. Enjoy!
The Fine Print:
Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
The Fine Print:
Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
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10 comments:
Intracellular rings, some with multiple infection per RBC. Some rings stuck to the side of the cell. I would favor Plasmodium falciparum infection.
Clearly a malaria (Plasmodium) infection. I can see nice ring stage parasites.
It could be mixed infection of plasmodium Falciparum and Vivax since some of them contain one ring some 2
Multiply infected rbc's with appliqué forms = Plasmodium falciparum.
BW in Vt
Plasmodium falciparum
West African or East African? It's relevant to the question of mixed P. falciparum/P. vivax infection.
Most West Africans are Duffy antigen negative.
falciparum
Clearly a Plasmodium infection, but hard to distinguish which species. Based on the red cell size, which seems to be larger I will say it is a vivax or ovale infection. Based on the schizonts could it be vivax (up to 16) or falciparum (up to 32) so it's hard to say. Based on the ring form, which seems to be fine with delicate double chromatin dots and applique form I will say is a falciparum ring form. So without knowing where the patient come from I will guess is most likely a vivax malaria infection, less likely a mixed vivax/falciparum infection, and remotely an ovale infection.
Present are multiple infected rbc's containing 1 or more ring form malaria parasites. The rbc's don't seem to be enlarged and the fact that there are multiple ring forms within single cells suggests p.falciparum. The ring forms are discrete with a tidy appearance and present with marginal forms. There appear to be no amoeboid ring forms, suggesting against P.vivax as the other species which presents with poly-infected cells, with exception of perhaps one form in the third image, though this is inconclusive since it could easily be a young trophozoite/slightly more mature ring form. The parasitaemia appears to be moderate judging by the number of ring forms present on the thick smear in image 1. The only other species of plasmodium which could present in this P.knowlesi, although it is absent from Africa so can likely be dismissed.
Given all this information, I see nothing here to suspect a vivax, ovale or malariae mixed infection. I am going to say it is a P.falciparum mono-infection.
no erythrocytes are enlarged, no Schuffner dots multiple infections : Pl. falciparum
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