August, 2005

Case 161:
A 50-year-old returned to the United States after working with a missionary group in Mali and Senegal for 10 years.  He went to a local hospital with a low-grade fever for 2 days.  The physician ordered a blood film examination and thick and thin films were made and stained with Giemsa.  Figures A-D show the objects, ranging in size from 236 to 245 micrometers, that were seen on the thick blood film.  Figures A and C were captured at 400× magnification and Figures B and D were captured at 1000× magnification.  What is your diagnosis?  Based on what criteria?

A	B

C	D

Click here for the answer to Case 161.

Case 162:
A 6-year-old girl complained to her parents that her head was itchy after returning from a 4-week summer camp in the southeastern United States.  Her parents took her to the doctor where she was examined.  The doctor observed small, whitish objects located near the base of hair shafts on the scalp.  Although the physician was able to make a diagnosis based on what he observed on the patient's scalp, he did collect a few hairs to examine under the microscope.  Figure A shows the objects that were found on the girl's head and Figure B shows a close up of the objects that were found on the girl's hair shafts.  What is your diagnosis?  Based on what criteria?

A	B

Click here for the answer to Case 162.

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.