February, 2006

Case 173:
A 29-year-old missionary lived in Gabon and Cameroon for one year.  Eight months into her stay, she went to a medical clinic with complaints of headache, fever, chills, and some diarrhea.  She reported to the physician that she did not adhere consistently to her malaria prophylaxis regime.  The physician ordered a blood film examination; thick and thin blood films were made and stained with Wright's.  Figures A-D show objects that were seen on the thin blood film.  What is your diagnosis?  Based on what criteria?  Would you recommend any laboratory confirmatory test to make the diagnosis specific?

A	B

C	D

Click here for the answer to Case 173.

Case 174:
A teenager underwent surgery for a traumatic injury to his abdominal cavity.  Apart from the injury, the surgeon noticed some necrosis around the youth's appendix.  A biopsy of that area was obtained and sent to the pathology department.  Figures A-D show what was observed on one of the hematoxylin and eosin (H & E) stained slides of tissue section.  Figures A, B and D were taken at 200×, and Figure C was taken at 400× magnification, respectively.  What is your identification of this additional finding?  Based on what criteria?

A	B

C	D

Acknowledgement: This case was kindly contributed by the South Carolina Department of Health and Environmental Control, Bureau of Laboratories.

Click here for the answer to Case 174.

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.