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Research ArticleClinical Practice

Malaria rapid diagnostic test and Giemsa – stained peripheral blood smear discrepancies in the diagnosis of Plasmodium ovale infection in New England

Seble Aregawi, Lei Li and Caterina M. Miraglia
American Society for Clinical Laboratory Science April 2017, 30 (2) 75-83; DOI: https://doi.org/10.29074/ascls.30.2.75
Seble Aregawi
Boston Medical Center, Boston, MA
MLS(ASCP)
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Lei Li
Boston Medical Center, Boston, MA
MD, PhD
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Caterina M. Miraglia
Department of Medical Laboratory Science, University of Massachusetts, Dartmouth, MA
CM
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  • For correspondence: caterina.miraglia@umassd.edu
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  • Figure 1.
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    Figure 1.

    Peripheral blood smear from the patient demonstrating two fimbriated erythrocytes with ring form trophozoites of P. ovale. Giemsa stain. x1000.

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    Figure 2.

    Peripheral blood smear from the patient demonstrating enlarged erythrocyte with ring form trophozoites of P. ovale. Giemsa stain. x1000.

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    Figure 3.

    Peripheral blood smear from the patient demonstrating a schizont form of P. ovale. Giemsa stain. x1000.

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    Table 1.

    Report of relevant laboratory testing at time of admission

    TestPatient ResultReference Range for Adult Female
    Hematology
    Red blood cell count3.53 × 1012/L*L4.00-5.20 × 1012/L
    White blood cell count1.9 × 109/L*L4.0-11.0 × 109/L
    Hemoglobin8.7 g/L*L11.8-16.0 g/L
    Hematocrit27.3%*L36-44%
    Platelet count26 × 109/L*L150-450 × 109/L
    D-dimer888.74 nmol/L (2,685 ng/mL)*H<80.43 nmol/L (<243 ng/mL)
    Chemistry
    Sodium136 mmol/L136-142 mmol/L
    Glucose6.60 mmol/L*H3.9-6.1 mmol/L
    Total calcium8.8 mmol/L*H2.1-2.8 mmol/L
    Total protein0.05 g/L*slightly L0.06-0.08 g/L
    ALT27 IU/L*H8-20 IU/L
    AST35 IU/L*H8-20 IU/L
    Total Bilirubin22.24 umol/L*H5.0-21.0 umol/L
    Direct Bilirubin8.55 umol/L*H1.7-5.1 umol/L
    Urinalysis
    ClarityCloudyClear
    ColorYellowPale yellow, yellow
    Protein1 +*HNegative
    Blood1 +*HNegative
    Microbiology
    Comprehensive respiratory panelNegativeNegative
    Blood culture (anaerobic and aerobic)NegativeNegative
    Urine cultureNegativeNegative
    Antibody for Anaplasma, Erlicha, Babesia, LymeNegativeNegative
    • Low (L), High (H), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST).

  • Table 2.
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    Table 3.

    Parasitemia Levels for Positive Blood Smears

    Samples negative for malaria antigens with positive P. ovale smear (5/178)Parasitemia (%)
    1<0.1
    20.1
    30.1
    40.7
    51.2
    Sample negative for malaria antigens with positive P. ovale or P. vivax smear (pending confirmation from CDC) (1/178)Parasitemia (%)
    1< 0.1
    Samples positive for T1 only with positive P. falciparum smear (7/178)Parasitemia (%)
    1<0.1
    20.1
    30.1
    40.1
    50.2
    60.2
    70.3
    Sample positive for T2 only with positive Plasmodium species not falciparum smear (1/178)Parasitemia (%)
    10.3
    Samples positive for T1 & T2 with positive smear for P. falciparum (10/178)Parasitemia (%)
    10.3
    20.8
    30.9
    40.9
    50.9
    61.3
    71.3
    82.0
    98.3
    1010.7
    Sample positive for T1 &T2 with positive smear for P. ovale (1/178)Parasitemia (%)
    10.1
    Sample positive for T1&T2 with positive smear for Plasmodium species (pending species confirmation from the CDC) (1/178)Parasitemia (%)
    10.9
    Sample negative for malaria antigens with positive smear for Babesia spp. (2/178)Parasitemia (%)
    10.2
    20.9
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American Society for Clinical Laboratory Science: 30 (2)
American Society for Clinical Laboratory Science
Vol. 30, Issue 2
Spring 2017
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Malaria rapid diagnostic test and Giemsa – stained peripheral blood smear discrepancies in the diagnosis of Plasmodium ovale infection in New England
Seble Aregawi, Lei Li, Caterina M. Miraglia
American Society for Clinical Laboratory Science Apr 2017, 30 (2) 75-83; DOI: 10.29074/ascls.30.2.75

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Malaria rapid diagnostic test and Giemsa – stained peripheral blood smear discrepancies in the diagnosis of Plasmodium ovale infection in New England
Seble Aregawi, Lei Li, Caterina M. Miraglia
American Society for Clinical Laboratory Science Apr 2017, 30 (2) 75-83; DOI: 10.29074/ascls.30.2.75
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Keywords

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