Monday, November 2, 2020

Case of the Week 613

This week's case is something that we only occasionally get to see in my laboratory - kindly donated by Dr. Ryan Relich. The patient presented with a past history of malaria, and she had not completed her full course of anti-malarial therapy. Therefore, her physician ordered peripheral blood films which revealed the following. Travel history is unknown at this time. It's a little hard to tell from the images, but the nuclei go to the tip of the tail.



Idzi P. said...

Thread-like tail with nuclei running up to its tip. Diameter comparable to the white blood cells’ nuclei. Surely this would be Loa loa
In one picture I seem to discern even one of the hernia too.
Mansonellas are ruled out by its thickness. A nice trick is to compare the diameter of the microfilaria to the nuclei of the white blood cells. Mansonella would be half of the WBC nuclei’s diameter while the others are more or less the same.

Anonymous said...

Thank you Dr. Pritt for the “tell tail”. Though the sheath is faint, it is discernible. With nuclei going to the end of the tail and no pink staining of the sheath we can rule out both species of Brugia as well as Wucheria. The only remaining sheathed microfilarium is Loa loa.
Florida Fan

Sir Galahad said...


Bernardino Rocha said...

Agree with Loa Loa.

William Sears said...

Loa Loa microfilaria. My guess is a peace corp volunteer in Cameroon as they all seem to be.

If there are any issues NIH can help with in the patient's care, let us know. Happy to help if need be.