This week's case features some objects on unstained wet preparations of whole blood. What are we seeing here? How do you process blood specimens in your laboratory for this type of organism?
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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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8 comments:
filariasis
Thank you Dr. Pritt. This is the first time I see a microfilarium in vivo. We would make thin blood smears, fix them in absolute methanol and stain them both with Giemsa and Hematoxylin stains. The reminder, we would perform the Knott’s concentration, lysing the blood in 2% formalin and centrifuge the lysis to concentrate the microfilaria. Giemsa and Hematoxylin smears will be made for identification. Stained smears and remaining samples will be forwarded to State and CDC for confirmation as well as epidemiology investigation.
Oops, I forgot to call the physician for the patient travel history as well as other pertinent clinical information.
Very cool to see live microfilaria in whole blood but as an mainland American hospital lab we'd never think of looking at a whole blood wet mount. This would probably come to the lab as a malaria request as that would be orderable in EHR so would make thick and thin smears. IF we saw these or didn't write off as cotton fibers would then send the CDC whatever they wanted.
This is a microfilaria of a filarial worm. It needs staining to diagnose the species. Also the timing of taking the blood specimen if diurnal or noctornal, the clinical picture and the geographic area will help to diagnose the parasite species.
I work at a Veterinary Diagnostic Lab. We see microfilariae of Dirofilaria immitis in dog blood. We prefer the modified Knott's test over a wet mount to confirm D. immitis. Acanthocheilonema reconditum is another nematode that also produces mf in dogs in the U.S. A modified Knott's is very helpful to differentiate between the two.
This is amazing!
Thank you! It was fun to take the videos.
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