January, 2005

Case 147:
A 75-year-old man had gastrointestinal bleeding while in Nigeria and received 8 units of whole blood that was reportedly imported from India.  After his return to the United States two months later, he experienced fever (101º) and chills.  Blood smears were submitted to a laboratory; one Plasmodium species was identified but assistance was requested for identification of a possible second species.  Figures A-F were observed on a Wright’s-Giemsa stained thin smear.  What is your diagnosis and species determination?  Based on what criteria?

A	B

C	D

E	F

Click here for the answer to Case 147.

Case 148:
A public health laboratory sent images to DPDx for telediagnosis assistance to confirm their parasite identification of a 160 micrometer long object.  The patient was a refugee from Africa.  Figure A shows the object in a formalin-ethyl acetate (FEA) concentrated wet mount.  What is your diagnosis?  Based on what criteria?

A

Acknowledgement: This case was kindly contributed by the Vermont Department of Health Laboratory.

Click here for the answer to Case 148.

Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving.  On rare occasions, clinical histories given may be partly fictitious.