Hematology Case 3

Presented By Dr Mohammed Salmeen Bazuqamah

Released on 01-05-2019

Patient Data

30 yrs. old Male , illegal Somalis immigrant

Clinical Data

Sudden Fever , Chills, Headaches, muscle or joint aches , nausea

Related Laboratory Results

WBC: 3.33x10³/ul

RBC: 4.42x10⁶/ul HGB: 12.4 g/dL

HCT: 37.6 % MCV: 85.1 fl

MCH: 28.1 pg MCHC: 33 %

PLATELETS: 14X10³/ul

Differential Cell count:

NEUTRO: 61% LYMPHO: 25.8%

MONO: 6.9% EOSINO: 6%

BASO: 0.3%

Provisional Diagnosis

Diagnosis of Malaria was suspected by ER physician

Case Picture(s) / Photo(s)

Thin Blood Film

Thick Blood Film

Comment / Findings

Spirochetes found in Peripheral smear in both thin and thick film

Final Diagnosis

Relapsing Fever (Borreliosis)

Additional Note

  • Spirochete from Greek for “coiled hair”
  • Thin (0.1-0.5 µ) , helical, long (5- 20 µ),, Gram –ve bacteria, motile by periplasmic flagella.
  • 3 Genera are pathogenic to human: Treponema , Borrelia , Leptospira.

Borrelia: Can be seen by light microscopy, stained by Giemsa or Wright stain but Not for Lyme disease (here bacteria are rarely seen in blood)

Diagnosis is usually performed by Giemsa staining of thin blood smears, using the same dye as for malaria diagnostics.