Hematology Case 3
Presented By Dr Mohammed Salmeen Bazuqamah
Released on 01-05-2019Patient 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.