Monday, March 27, 2023

Case of the Week 713

 Here is combination case from my archives showing a particular parasite in 3 different preparations of vaginal secretions.

Conventional Pap smear:



ThinPrep Pap smear:



Giemsa-stained cytoprep:


Identification?

13 comments:

  1. Is this a trick question with Trichimonas

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  2. My favorite teaching flagellate T. vaginalis. For sure a wet mount from a direct specimen or a culture is impressive, yet the Giemsa stain smear will show the most details of this flagellate anatomy including the basal body, the nucleus, the undulating membrane, the axiostyle, the flagella. Sometimes you may find a dividing Trichomonas with two nuclei. For teaching smears, I used an albumin coated slide of Pathology, spread a drop of a 48 hours culture into a nickel size smear, air dry and fix in methanol. Let the smear air dry and stain with Giemsa stain. For some reason, HE and Pap smears don’t exhibit the organism as well as Giemsa. Depending on the orientation of the organism, we need to observe several organisms to visualize all the organelles of T. vaginalis as shown in teaching drawings of the book.
    Florida Fan

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  3. Wow! I definitely like the Giemsa stained one the best.

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  4. Trichomonas vaginali. Bellissimo!

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  5. T. Vaginalis! I was just talking about this organism at our student health clinic huddle. Maybe you would be willing to share some insightful information on common and maybe uncommon transmission methods for this parasite? We are aware it is sexually transmitted, but wondering if other means of transmission are out there such as environmental or is it exclusively from sexual activity by vaginal/ male urethra sources? I was also reading the only form it takes is the trophozoite (no cysts??) I told my clinic staff I would put together some information on this parasite and share at the next staff meeting and potentially offer awareness to the student population at our next "Free STI Clinic". Thanks always for your fun blog!

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  6. To "Unknown" - sure! I will add some information about transmission in my post :)

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  7. Off topic question, sorry but i couldn't find clear answer. For stool microscope examination, what's lugol concentration should be used ? 2% Lugol ? Should it be used straight or after 1:5 dilution ?

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    1. Hi neoexplorer!
      We use saturated iodine crystals in a potassium-iodine solution. Formula according to D’Antoni. Dissolve 10g of KI in one liter of distilled water, then add this solution bit by bit to 15g of finely crushed I2 crystals (use a mortar), mix and transfer supernatans each time to a dark bottle, repeat until KI-solution is finished, then add remaining crushed I2 crystals to the dark bottle. This is the saturated stock solution to be kept refrigerated and shaken every now and then. Filter this stock solution right before use to obtain a working solution. Working solution can be used for one month at room temperature in a tightly closed dropper bottle.
      Hope this is of help.
      Kind regards,
      Idzi

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    2. Note that other lugol-solutions exist that may work as well as the one that I described. I just shared the formula that we use in our lab…

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    3. Thank you very much Mr Idzi P. This is helpful.

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  8. We don't use iodine in my lab so I can't comment on the concentration. Perhaps one of our other readers can?

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    1. Ok thanks. Very beneficial blog by the way thank you.

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