Assuntos
Doença de Chagas , Adulto , Cardiomiopatia Chagásica/diagnóstico , Cardiomiopatia Chagásica/tratamento farmacológico , Cardiomiopatia Chagásica/transmissão , Doença de Chagas/diagnóstico , Doença de Chagas/tratamento farmacológico , Doença de Chagas/transmissão , Criança , Emigração e Imigração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/etnologia , Gravidez , Complicações Parasitárias na Gravidez/parasitologiaRESUMO
OBJECTIVE: To present a clinical diagnostic conundrum of unidentified structures in a blood smear from a patient with Plasmodium vivax malaria. CLINICAL PRESENTATION AND INTERVENTION: A 37-year-old Ethiopian male presented with a 4-month history of chills, chronic diarrhea and weight loss. He was diagnosed with P. vivax malaria, advanced HIV infection and Isospora belli enteritis. Unidentified structures initially confusing to the diagnosticians were seen in blood smears taken on admission. The structures were initially considered to represent atypical spirochetes, but were later identified as microgametes and other exflagellation forms of P. vivax. The patient recovered after receiving adequate treatment for his infections. CONCLUSION: This case illustrates that exflagellation may be observed in blood smears from patients with P. vivax malaria. Size and morphological characteristics differentiate malaria microgametes and other exflagellation forms from microfilaria, spirochetes and trypanosomes.
