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Monthy Case Studies - 2002
Case #89 - August, 2002
A 55-year-old missionary traveled to Guatemala, the Dominican Republic, and the Ivory Coast in a three month period. The man fell ill during a church conference after returning home from the trip. He was taken to an emergency room with a high fever (102.5°F), chills, aches, profuse sweating, nausea, and vomiting. He had taken malaria prophylaxis while on the Ivory Coast, but stopped taking it upon returning to the United States. The objects in the images below were seen in his Giemsa stained blood smears (Figure A is a thick smear; Figures B and C are thin smears). What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Answer to Case #89
This was a case of malaria caused by Plasmodium falciparum. Diagnostic features observed included:
- the presence of only ring forms.
- thin, delicate rings, some with double chromatin dots.
- the presence of appliqué forms (periphery of RBC).
- no enlargement of infected RBCs.
- multiply-infected RBCs.
More on: Malaria
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.
