July, 2009

Case 255
A 36-year-old man was admitted to the hospital with fever, chills, headache, and myalgia.  The patient recently returned to the United States following a month-long trip to Rwanda to visit family.  Blood was collected in EDTA and sent to the Hematology Department for work-up.  Figures A-F show what was observed on a thin smear made from the blood, stained with Giemsa.  All images were captured at 1000x magnification.  What is your diagnosis?  Based on what criteria?

A	B

 

C	D

E	F

Click here for the answer to Case 255.

Case 256
A 25-year-old refugee from Myanmar was screened for parasites at a local clinic in Tennessee.  Stool specimens were collected in 10% formalin and polyvinyl alcohol (PVA) and sent to the state health laboratory for ova and parasite (O&P) work-up.  Figures A-D show what was observed in a concentrated wet mount made from the formalin-preserved stool.  Figures A and B show what was observed under brightfield microscopy; Figures C and D show the same fields, respectively, observed under UV microscopy. All images were captured at 400x magnification.  The objects of interest measured on average 17 micrometers long by eight micrometers wide. What is your diagnosis? Based on what criteria?

A	B

 

C	D

Acknowledgement: This case, and the specimen from which images were taken, were kindly provided by the Tennessee Department of Health, Laboratory Services.