Plasmodium Ovale on Blood Smear Emory_MedMicro @Emory_MedMicro #Plasmodium #Ovale #povale #Blood #Smear #microscopy #clinical

Plasmodium Falciparum Blood Smear. Key features suggesting Plasmodium falciparum: - extreme parasitemia - normocytic RBCs (vivax, ovale prefer big reticulocytes) - thin trophozoites - multiples per RBC - "applique" edge forms - P. falciparum causes ~75% of human malaria cases - Banana-shaped gametocytes are only in P.f. but rare in blood smears - don't count on seeing these! - Seeing ONLY trophs/rings, no schizonts/gametocytes, (in my experience) is more common in P.f. Rich Davis, PhD, D(ABMM), MLS @richdavisphd #Plasmodium #Falciparum #Blood #Smear.#peripheral #clinical #microscopy #microbiology #malaria

Plasmodium falciparum trophozoites (and crenated red blood cells) - Blood Smear A classic presentation of Plasmodium falciparum malaria trophozoites (young, ring-stage) in a thin blood smear. RBCs (but interestingly not infected RBCs) are "crenated" (shrunken w/ scalloped edge) Rich Davis, PhD, D(ABMM), MLS @richdavisphd #trophozoites #Plasmodium #falciparum #Blood #Smear #peripheral #clinical #microscopy #malaria #microbiology

Plasmodium Falciparum Gametocytes on Blood Smear. Banana-shaped gametocytes are only seen in Plasmodium falciparum but rare in blood smears - don't count on seeing these! Seeing ONLY trophs/rings, no schizonts/gametocytes, (in my experience) is more common in P.f. Rich Davis, PhD, D(ABMM), MLS @richdavisphd #gametocytes #Plasmodium #Falciparum #Blood #Smear.#peripheral #clinical #microscopy #microbiology #malaria

P. falciparum ring forms on a thin smear - Dr. Christina Dean @deanchr3 #Plasmodium #falciparum #Rings #Smear #Hematology #Microscopy #Clinical #Pathology #malaria

Plasmodium - Identification Algorithm • P. falciparum: RINGS AND GAMETOCYTES PREDOMINATE, Small delicate rings, <1/3 size RBC, Headphones forms, Applique forms, Multiple rings/RBC, High parasitemia, Banana-shaped gametocytes • P. malariae: ALL STAGES PRESENT, Thick rings, ≤ 1/3 size RBC, Basket, band forms, Rosette schizonts • P. vivax: ALL STAGES PRESENT, Ameboid trophs, >1/3 size RBC, Schizont with >12 merozoites • P. ovale: ALL STAGES PRESENT, Trophs more compact, > 1/3 size RBC, 1/3 oval shape, fimbriated edges Bobbi Pritt, MD @ParasiteGal #Plasmodium #Identification #Algorithm #pathology #smear #microscopy #malaria

Plasmodium vivax on peripheral smear A college student presents w/ headache, fever, chills. Returned 2 days ago from Brazil: rafting & camping trip for two weeks. Diagnosis? Plasmodium vivax. Diagnostic morphologic features enlarged infected rbc up to 1.5 x normal size amoeboid trophozoite with tenuous pseudopodial processes, schizont with 16 merozoites (P. ovale has 8-10 on average) travel history of the patient Infected RBCs may not present stippling so important to use Giemsa stain at proper pH. Doing so can allow one to observe Schüffner’s dots (stippling), a morphologic feature which is only associated with P. vivax & P. ovale. travel history to Brazil (P. ovale not in New World) Indiana University Infectious Diseases Fellowship @IUIDfellowship #PlasmodiumVivax #pvivax #malaria #peripheral #smear #blood #clinical #pathology

Babesia spp. on Peripheral Blood Smear Microscopy - Multiple small parasites per RBC - "maltese cross" - 49% parasitemia Rich Davis, PhD, D(ABMM), MLS @richdavisphd #Babesia #clinical #microscopy #microbiology #peripheral #blood #smear

Malaria - Plasmodium Life Cycle 1) Mosquito takes a blood meal (injects sporozoites) Human Liver Stages 2) Infected liver cell 3) Schizont 4) Ruptured schizont 5) Human Blood Stages 6) Ruptured schizont 7) Gametocytes Mosquito Stages 8) Mosquito takes a blood meal 9) Microgametocyte entering macrogamete 10) Ookinete 11) Oocyst 12) Ruptured oocyst #Malaria #Plasmodium #lifecycle #diagnosis #pathophysiology #infectiousdiseases #cdc #parasite

Ellipsoid / Football shaped parasite eggs on Microscopy - Mnemonic by Size - Come (30um) - Chlonorchis - Discover (60um) - Dibothriocephalus - Parasites (90um) - Paragonimus - Forever (120um) - Fasciola Emory_MedMicro @Emory_MedMicro #Ellipsoid #Football #parasite #eggs #Microscopy #Mnemonic #size #diagnosis #microbiology

Streptobacillus moniliformis on peripheral smear and culture microscopy - blood culture; patient w/ outdoor exposure - identified by MALID (RUO database) Causative agent in Rat-bite fever. Rich Davis, PhD, D(ABMM), MLS @richdavisphd #Streptobacillus #moniliformis #blood #smear #clinical #microscopy #microbiology #ratbite