Page 78 - MNU-PM503 Parasitology practical book

Pharm D- Clinical Pharmacy Program Third Level Parasitology and virology (PM503)

Case study (13):

A 29-year-old man was living and studying in Damietta. He was complaining of

fever and swelling in the right lower limb 4 years ago. Clinical examination revealed

enlarged right inguinal lymph nodes. Lymphangitis and lymphoedema was observed

in his lower limbs and his scrotum with thickened spermatic cord-

The patient's symptoms, combined with his geographical area of origin, created

a suspicion of a parasitic infection. Blood sample was drawn and sent to the laboratory

for a complete blood count and thin and thick blood smears.

Eosinophilia (28%) was observed. Blood smears were stained by Delafield's

haematoxylin method and examined microscopically. A few number of sheathed

microfilariae averaging 260 u in length with bluntly rounded anterior portions, were

revealed. A large number of distinct nuclei were seen in the microfilariae. The nuclei

did not extend to the tips of the tails which tapered to a point.

QUESTIONS

1- Which parasite is causing this patient's symptoms?

2- How is this infection differentiated from the related helminths?

3- Which insects act as the intermediate hosts for these parasites?

4- How is the diagnosis of this infection performed?

5- What is the best time for blood sampling in the diagnosis of this infection?

6- What is the value of the provocative test in this infection?
7- Describe the morphological characteristics of other sheathed microfilariae

which may be detected in a blood smear.
8. Why was Delafield's haematoxylin stain used?

9. Which drugs may be used to treat this infection?
10. How can we control this parasitic infection?

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