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Case #274 - April, 2010

A patient from Pakistan was admitted to a medical facility with non-cirrhosit portal hypertension, hepatic vein thrombosis, IVC stenosis and respiratory failure. No eosinophilia was reported at the time patient was admitted, but was present at 7% the next day. A blood smear was made at midnight and stained with Wright-Giemsa. Figure A shows what was observed by the attending pathologist at 1000x magnification. What is your diagnosis? Based on what criteria?
Case274_A

Figure A

Case Answer

The objects in this case were artifacts (fungal elements, possibly Helicosporium sp. or related) and a diagnosis was made of No Parasites Found (NPF). Fungal hyphae and conidia are not uncommon airborne contaminants in the laboratory. If such objects were to alight on a drying blood smear, they could get stained, observed and possibly misinterpreted as parasites. In this case, the objects most-closely resembled a microfilaria. Careful examination of morphologic features, as well as accurate measurements, should be performed to ensure a proper diagnosis.

More on: Artifacts

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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DPDx is an education resource designed for health professionals and laboratory scientists. For an overview including prevention and control visit www.cdc.gov/parasites/.

  • Page last reviewed: August 24, 2016
  • Page last updated: August 24, 2016
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