Hello everyone, how are you all? I hope you all are doing well and great and i am too. My semester exams are over i didn't prepared anything for exams but i have attempted all questions that even i didn't expected. Practical exams i did well but need bit more inprovement.

Today i would like share about malaria parasite how i found in peripheral smear.

I have asked fot peripheral smears which are having low hemoglobin, low platelet count. The patient Hemoglobin is 4.12 g/dl and platelet count is 9390 and when i started seeing peripheral smear slide, i have seen many ring forms and few double dots(headphone) appearance forms inside the red blood cells. My mind was to do manual platelet count as platelet count is very less and it may need RDP(random donor platelets) and SDP(Single donor platelets) if manual platelet count also comes less than 10000/cumm. But these ring forms gradually attracted my eyes towards them because every field i am finding about 4-5 ring forms inside the RBC. These are classical images that may be used for undergraduate students for their practicals and for post graduates too. I will share the images that i captured.

Case

A 27 year female came to hospital with fever, breathlessness since 1 week and CBP(complete blood picture) results are displayed below

The patient is having bicytopenia.

Microscopic images

These are the double dot or headphone appearance which will be seen in plasmodium falciparum infection.

These all are ring forms which are seen in both plasmodium vivax and plasmodium falciparum. So we need correlation with malaria rapid card test too for speciation. Or else we can give report as plasmodium falciparum because of the double dot or headphone appearance forms.

I have shared some more images without labelling it because i want you have to identify those ring forms.

As it is rainy season dengue and malaria diseases are common and we need to be take care of ourselves. Diagnosing early is needed so that patients get treatment on time will not go into complications cerebral malaria.

Hope you have understood how malaria parasite are identified.

References

• Essentials of Medical Parasitology
  by Apurba S Sastry, Sandhya Bhat

Thanks for reading,
With regards,