Monday, September 25, 2017

Case of the Week 461

This week's case was donated by Dr. Peter Gilligan. The patient is a toddler who presented with high fever and tachycardia. The patient had come to the United States from Uganda 16 months prior to presentation and had not traveled outside of the United States since. The following are representative fields from the peripheral blood smear.








Identification?
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5 comments:

  1. AnonymousSeptember 25, 2017 at 5:42 PM

    Relapsing form of malaria, ring forms in reticulocytes; I will venture to guess P. vivax as suggested by more numerous merozoites in schizonts.

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  2. AnonymousSeptember 25, 2017 at 5:51 PM

    I agree that Plasmodium vivax is the most likely diagnosis.

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  3. AnonymousSeptember 25, 2017 at 7:06 PM

    The patient being in the US for more than a year indicates a relapse of the infection. Infected red cells are slightly larger than non infected red cells help us eliminate P. malariae and P. falciparum being the causative agents. We see schizonts with more than 12 merozoites and this rules out P. ovale. All stages of development are present.
    All clues point to a diagnosis of P. vivax.

    Florida Fan

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  4. AnonymousSeptember 27, 2017 at 9:50 AM

    The plentiful merozoites, plus evidence of relapse point me immediately to P. vivax. None of the other parasite forms in the photos contradict that diagnosis.

    Mark Fox

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  5. Carlo Alberto VarlaniSeptember 27, 2017 at 10:54 AM

    Plasmodium vivax...

    ReplyDelete