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Case #519 - July, 2020

In Singapore, a 54-year-old man with an extensive travel history to Vietnam, Thailand, and France presented to a clinic with prolonged fever, urticarial rash, and muscle aches. Results of his blood work showed eosinophilia and elevated creatinine kinase. A muscle biopsy was performed and stained with hematoxylin and eosin (H&E) for histopathological examination. Figures A and B show what the pathologist observed at 400x and 1000x respectively. What is your diagnosis?  Based on what features?

This case and images were kindly provided by Dr. Rao Pooja Rao, at Tan Tock Seng Hospital, Singapore.

Figure A

Figure A

Figure B

Figure B

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: December 10, 2020