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Answer to Case of the Week 52

Question 1. Malaria due to Plasmodium malariae infection. Notice that there is no stippling present, and that the infected red blood cells are the same size or slightly smaller than the neighboring uninfected cells. Also shown here are the ‘classic’ stages of P. malariae in peripheral blood.

Question 2. From top to bottom, the forms and nicknames are:
a. Early stage trophozoite or Ring form (Nicknamed bird’s eye because the chromatin dot appears to be inside the ring like an eye)
b. Late stage trophozoite (Nickname: Band form)
c. Late stage trophozoite (Nickname: Basket form)
d. Mature Schizont (Nicknamed Rosette, or ‘daisy head’ because the merozoites line up around a central ball of granular brown-yellow pigment like petals on a flower).

Thanks to everyone for their comments!

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Date
June 1, 2010
4:30 pm

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Category
General

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A few smiling faces…

A couple “smiley” faces from a bone marrow we reviewed a few months ago.  I haven’t posted in a while, but promise to publish a couple interesting cases soon!

“This is what your healthcare is going to look like.”

Last month I was in a post office standing in a particularly long line for that location. The line eventually extended beyond the lobby and outside the doors. The delay seemed to stem from the fact that this was between 12 and 1 PM when there were several customers and only 1 staff member during a busy day and time. The situation was made worse by the fact that the staff person was trying to assist an elderly customer who was asking for an unusual denomination for a particular stamp to go to a particular place somewhere in the world. And she wanted to write a check and appeared to have a terrible tremor which made writing clearly difficult. Plus you have to retrieve and show valid photo ID when presenting the check to the post office.

These things happen. It was going to cost me an extra 10-15 minutes.

An equally elderly customer about 5 people behind me yelled out “This is what your healthcare is going to look like”.

I disagree. We can only hope healthcare reform allows for what I consider a normally efficient service.

For some of the shortcomings of the US mail, with its rigid policies and procedures I can count on 1 finger the number of times an intended delivery or sent item was not received over several decades of using the US mail for pen pals, college applications, med school applications, licensing forms and business transactions. Of course, e-mail and other electronic services have minimized the necessity for traditional “snail mail” services which has affected the bottom line for the quasi-governmental organization. I find the need for delivery confirmation or certified letters to be negligible given the time and accuracy of mail delivery.

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Date
May 19, 2010
4:22 pm

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Category
Cases, Microbiology

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Case of the Week 52

The following images were taken from a Giemsa-stained peripheral blood smear. The different stages of the organism shown represent a single species, and each stage is characteristic for this species. The stages are so characteristic, in fact, that each has an ‘unofficial’ name (e.g. nick-name) or description.

Question 1 – What organism (genus and species) is shown?
Question 2 – What is the nick-name of each stage?

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Answer to Case of the Week 51

Answer: Not a parasite. Most closely resembles pollen.

I included this case since the object in some of the photos resembles a helminth egg (Toxocara canis or Capillaria spp. comes to mind). The key to recognizing that this is not an egg is in the last photograph which clearly shows the pores in the thick outer layer and triangular shape of the inner structures. There are no human parasites that have eggs in this configuration.

Case of the Week 51

The following were seen in a concentrated wet preparation of stool. No history is available. Identification?

40X objective

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