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Monthy Case Studies - 2003
Case #107 - May, 2003
A 37-year-old woman experienced fever, weight loss, and weakness for several months after traveling to Dubrovnik (Croatia). Physical examination by her physician revealed a slightly enlarged liver and spleen. Figure A is an image from her bone marrow smears. What is your diagnosis? Based on what criteria?
Figure A
Acknowledgement: This case kindly provided by Dr. Eva Ban and Dr. Rossitza Todorova of the Microbiology Lab of St. Laszlo Hospital (Central Hospital of Infectious Diseases), Budapest.
Answer to Case #107
This was a case of leishmaniasis, caused by Leishmania sp. Figure A shows many amastigotes. Unfortunately, the primary morphological features (parasite nucleus [green arrow] and kinetoplast [black arrow]) can only be seen clearly in a few organisms circled in Figure A.
Since amastigotes of Trypanosoma cruzi are indistinguishable from those of Leishmania spp., factors such as clinical history, specimen type, geographical area, and serology results must also be considered when making the diagnosis. Culturing the parasites can provide a source of material for subsequent isoenzyme analysis for speciation.
Figure A
More on: Leishmaniasis
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.
