2013-04-10
Mystery cells, case #15
Who can tell the diagnosis?
A 50-year-old male from the State of Nevada was sailing his boat in the South Pacific for over a month. He would frequently eat raw shellfish and raw fish. He presented to a hospital in Nevada with muscle pain, numbness and headache.
A spinal fluid aspiration was done and the sample was prepared via cytospin run on a CellaVision® DM96 with the Body Fluid Application.
Total nucleated cell count of the spinal fluid: 815 × 10-6/Liter.
Differential white cell count:
32% Lymphocytes
52% Eosinophils
3% Basophils
13% Monocytes
Please share your suggested diagnosis!
Microscopic images of the spinal fluid:
35 thoughts on “Mystery cells, case #15”
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I’m impressed by all the correct answers. Must be folks from the Pacific Coast. Those of us Easterners learned something today!!
Sue from Atlanta, GA
I think parasitic infection can be occurred.
increase in eosinophils indicates parasitic infecction. Due to shellfish aconsumption, the intermediate host of parasite.probably Anisakiasis sp.
This site is educative most especialy to the medical laboratory science student
increase in momocytes indicates parasitic infecction. Due to shellfish consumption, the intermediate host of parasite.probably Anisakiasis sp
I think a parasitic infection caused by a species of angiostrongylus.
parasitic infection (Angiostrongylus Cantonensis)
Impresión diagnostica de una parasitosis por helmintos
Parasite infection due to eating raw salt water fish. Probably Anisakiasis.
Eosinophilic meningitis caused by parasitic infection.
parasitic infection
may be parasitic infection
Eosinophilic meningitis due to eating raw shellfish and fish.
Parasitic infection
Parasitic infection
Parasitic infection due to ingesting raw fish and shellfish.
It is eosinophilic meningitis caused by parasitic infection. In South Pacific, the most common endemic parasite is Angiostronglyes cantonensis.
parasitic infection or extreme allergic reaction to shellfish
Eosinophilia suggests he picked up a parasite from consumming raw fish and shellfish. My first guess would be Angiostrongyliasis due to the region and CNS involvement.
Parasite
Eosiniphillic meningitis caused by eating raw fish with a parasite
Possibly parasitic meningitis.
Parasite infection
Is it due to allergic reaction to shell fish ?
Best guess I have is Anisakiasis (roundworm).
Angiostrongylus canatensis, the rat lungworm larvae causes CSF eosinophilia after ingesting raw fish or shellfish from South Pacific area.
A roundworm, Anisakis simplex, infection.
Parasitic Meningitis caused by Gnathostoma spinigerum
parasitic infection. I like this idea!
This helps our lab to understand abnormals better.
Angiostrongylus cantonensis
Probably has a helminth infection.
Eosinophilia and symptoms c/w a parasite from the raw fish/shellfish. Possibly Paragonimus westermanii.
Elevatet WBC count – dominated of eosinophils .
Could be:
parasitic infections associated with eosinophilic meningitis.
Because he has been eating raw fish.
Thank You for an interesting case.
The photos show some lymphocytes and mococytes/macrophages – dominated of eosinophils.
Could be parasitic infections associated with eosinophilic meningitis, because he has been eating raaw fish.
Thank You for an interesting case. Nice photos of eosinophils.
My suggested diagnosis is eosinophilic meningitis due to Angiostrongylus cantonensis.