Case #290 - December, 2010
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A 31-year-old man was admitted to a local hospital with fever, chills, myalgia, and fatigue. His travel history included a two week work-related trip to Cambodia and a one week vacation in Connecticut immediately after that trip. His symptoms began about 3 days after returning from Connecticut. He indicated that he did take anti-malarial prophylaxis while in Cambodia but failed to take the remainder of his medication before going to Connecticut. Blood smears were ordered, stained with Giemsa, and examined. Figures A-D show what was observed at 1000x oil magnification. What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Figure D
Case Answer
This was a case of babesiosis caused by Babesia sp. Morphologic features included:
- pleomorphic and vacuolated intraerythrocytic ring-like parasites in normal-sized red blood cells.
- an absence of malarial pigment found in Plasmodium species.
In general, identification of Babesia to the species or strain level is not possible by morphology, and requires molecular analysis of a blood specimen. Regrettably, no pretreatment blood was available in this case for subsequent testing so the final diagnosis remains Babesia sp.
More on: Babesiosis
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 updated: August 24, 2016
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