Hello everyone, I am going to tell about an interesting and important case.
Case
Patient came with complaints of fever since 5 days. chills and rigors are present intermittently. Blood was drawn and sent for complete blood picture, peripheral smear and other serological investigations...
As i am in microbiology, received the sample and i made a smear with that sample. We received sample for malarial parasite.
Malaria is mainly caused by two parasites plasmodium vivax and plasmodium falciparum. Plasmodium falciparum is more dangerous than vivax because it causes cerebral malaria. So diagnosing these malarial parasites is so important.
Plasmodium vivax shows ring forms and amoeboid forms in it is trophozoite phase.
Plasmodium will be present in ring form, headphone, double dots appearanace.
Peripheral smear is the Gold standard in diagnosing malarial parasite. We have to look at peripheral smear and screen it very carefully to look for any parasite we are finding.
The peripheral smear was then dried and seen under oil immersion to look for malarial parasite and i have seen this.
Ring forms
Headphone appearance
The early trophozoites appears in different shapes if it is a plasmodium falciparum parasite. One of the shape is headphone appearance. I have shared that i found them in the peripheral smear.
So by above images i can conclude that i found ring forms and headphone and double dots forms. So li will give it as a Plasmodium falciparum.
Identifying malarial parasite is crucial part why because treatment depends on what diagnosis we are giving. It it is a plasmodium vivax then treatment will be chloroquine for 3 days and primaquine for 14 days as vivax cause relapse. So primaquine helps in preventing relapse.
But if it plasmodium falciparum then treatment is totally different. Artemesinin derivatives we will give along with antibiotics. For pregnant women we will avoid artemisinin derivatives in 1st trimester as they fetal abnormalities and we will give quinine later in 2nd and 3rd trimester we will give artemesinin. So this much of difference is there between plasmodium vivax and plasmodium falciparum. Thats why its very very important to diagnose malarial parasite cautiously.
References
- Essentials of Medical Parasitology
by Apurba S Sastry, Sandhya Bhat
Thanks for reading,
With regards,