Monday, October 14, 2019
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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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9 comments:
This a case of mixed Plasmodium species infection. From Plasmodium falciparum we can see the crescent-shaped macrogametocytes (2 bottom images). The first images reveals early trophozoites of Plasmodium ovale (enlarged and oval red blood cells, and Schüffner’s dots). Would recommend a chloroquine sensitivity test, and adicional molecular methods.
The infected red cells are enlarged and there is a "shy away" from adjacent red blood cell favor a diagnosis for P. vivax and ovale. The typical fimbriation of red blood cell and absence of ameboid trophozoite as well as the presence of Schuffner dots favor an identification of P. ovale.
The crescent shape gametocytes are conclusive clues to an infection with P. falciparum as well. This is also an indication of a more chronic rather than acute infection.
Overall, this is a mixed P. ovale and falciparum. We do not always have this situation even in endemic countries and such a finding like this is particularly special.
Florida Fan
Corresponde a una infección mixta por Plasmodium ovale y Plasmodium falciparum
Mixed infection P. Falciparum and P. Ovale
Plasmodium knowlesi is a parasite that causes malaria in humans and other primates. It is found throughout Southeast Asia, and is the most common cause of human malaria in Malaysia. Like other Plasmodium species, P. knowlesi has a life cycle that requires infection of a mosquito host and a warm-blooded host. The natural primate host of P. knowlesi is the long-tailed macaque; however mosquitoes that feed on infected macaques can bite and infect humans. Infected humans can develop severe malaria, similar to that caused by Plasmodium falciparum. P. knowlesi malaria is an emerging disease first recognized in humans in 1965 but increasingly recognized as a human health burden in the 21st century.
It's a Giemsa-stained mears of Plasmodium knowlesi infecting human red blood cells
This is a mixed infection with Plasmodium ovale and Plasmodium falciparum.
Very cool case and pictures! The morphology is consistent with a mixed infection with Plasmodium spp. The first five images show many diagnostic morphologic features: the infected RBCs are enlarged, they have an oval shape with jagged edges, Schüffner's dots are present in their cytoplasm, and infecting trophozoites are compact; these features are consistent with infection by Plasmodium ovale. The last two images show banana-shaped gametocytes which are diagnostic of Plasmodium falciparum. Since the morphology is definitive, diagnostic PCR is likely not needed. However, for treatment purposes, quantification of parasitemia is indicated. Empiric therapy based on the patient's travel history should be started (chloroquine resistant vs chloroquine sensitive) as well as a drug to cover the dormant hypnozoites of P ovale!
Santiago
The initial 5 images show Plasmodium ovale an the 2 last P falciparum gametocytes, but I see no Pf ring forms. Could this case represent a pts previously treated for suspected Pf monoinfection where as a P ovale coinfection was initially missed? This could explain why we only see Pf gametocytes that may not be killed by antimalarials and the reappearance of P ovale from liver hypnocoites as the pts was not given proper treatment for these liver stages when treated for suspected Pf monotherapy the first time.
I would like to know the travel and treatment history of this pts.
A case of P. falciparum and P. ovale mix infection. In the first slides, trophozoite of P. ovale in thin blood smears. There is the fimbriation and Schüffner's dots.In subsequent slides, gametocyte of P. falciparum in a thin blood smear.Diagnosis requires the use of an experienced microscopist or molecular diagnostic methods.
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