2013-01-08

The importance of scanning blood parasite smears under low power

” The images I want to share are amazing. Actually these are the first real ones I’ve ever seen in my career! People typically look at this kind of slides at high power and could have missed this if they did not look under low power at the feather edges and edges of smears.” Joan Dolasinski at Sharp Grossmont Hospital in San Diego, CA. wrote when she sent these amazing images to our blog.

Here are the patient details:
The patient is a 33-year-old African man who recently immigrated from Cameroon to the United
States. He presented to Grossmont Hospital ER with a chief complaint of a sudden headache in the occipital area, which had started 3 days ago as a sharp pain when he turned his neck. The pain went to the base of his skull and was associated with right hip pain and difficulty moving his right hip. He did not display photophobia, nausea, vomiting, diarrhea, fevers, or chills. He had lost about 6 pounds in the last month and occasionally experienced night sweats.

The images look like this:


What do you see in the different images and what do you think about the man’s condition?

This case and amazing images were sent to the CellaVision newsblast by Joan Dolasinski at Sharp Grossmont Hospital in San Diego, CA.

 

25 thoughts on “The importance of scanning blood parasite smears under low power”

  1. this is a picture of a microfilaria possibly loa,loa due to the presence of sheeting and nucleoli extending all the way to the tail
    very hard to distingush the type

  2. Beautiful Loa loa, nuclei extending to tip of tail and sheathed microfilaria. Actually had one patient in Auckland where they were able to film the adult worm migrating across cornea. Its fun making a wet prep from a buffy coat and watching the live microfilaria moving. Makes your skin crawl!!

  3. Looks like Loa loa. We always stress checking the feather edge and edges when performing diffs with our students.

  4. It is a roundworm and I am thinking the man has filariasis.it could be Wuchereria bancrofti..or Bruga malayi?

  5. Never seen something like this, consulting our books it seems to be some kind of filariasis, perhaps Loa loa.

  6. A very beautiful Loa Loa. Clinical details are interesting, I kind of assumed high fever and nausea would be present. Great case. Thank you.

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