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Case #460 - January, 2018

A 39 year-old man from Nigeria returned from visiting his country of birth with fever. A medical evaluation confirmed the fever and also detected low hemoglobin. A Binax-NOW rapid test for malaria showed a strong T1 band and a weak T2 band (Figure A). A blood smear was ordered and stained with Giemsa. Examination of a stained thin smear showed what is shown in Figures BI and the parasite density was calculated to be 0.5%. What is your diagnosis? Based on what criteria?

(This case and images were kindly provided by the Cadham Provincial Public Health Laboratory, Winnipeg, MB)

parasitic image

Figure A

parasitic image

Figure B

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Figure C

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Figure D

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Figure E

parasitic image

Figure F

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Figure G

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Figure H

parasitic image

Figure I

Case Answer

This was a case of malaria caused by Plasmodium falciparum. Morphologic features shown included:

  • Infected red blood cells (rbcs) normal size.
  • Some ring stage parasites with delicate cytoplasm.
  • Older trophozoites compact and some with malarial pigment.
  • No other stages observed.

In addition to the morphologic features, PCR testing results also revealed that only Plasmodium falciparum was present.

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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.

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  • Page last reviewed: March 5, 2018
  • Page last updated: March 5, 2018
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