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Monthy Case Studies - 2000
Case #44 - September, 2000
A 22-year-old woman from New York City traveled to Gabon for two weeks to visit distant relatives. Approximately two months after her return, she began to have fevers at fairly regular intervals of three days apart. She went to her health care provider after two weeks of being ill. Her physician asked if she had taken any kind of medications or received any inoculations before her trip to Gabon. She reported she had not taken anything. A sample of blood was obtained and a thin smear was prepared and stained with Giemsa. The objects shown below were seen in rare numbers on the stained blood film Figures A through D). What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Figure D
Answer to Case #44
This was a case of quartan malaria, caused by Plasmodium malariae. Diagnostic features observed were:
- band-form trophozoites in normal sized or smaller red blood cells (Figures B and C).
- a mature schizont with less than 12 merozoites and pigment that appears coarse and dark (Figure D). Schizonts can sometimes appear as a rosette when the merozoites are arranged around a mass of centrally located pigment.
- a sturdy ring-form trophozoite (Figure A) with large chromatin dot in normal sized or smaller red blood cell.
- a rounded gametocyte in normal sized red blood cell (Figure A).
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.
