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Blood (Intracellular) and Other Tissue Protozoa 117

CASE STUDIES

1. A middle-aged visitor recently arrived from the African continent for an extended
visit in the United States with relatives. Her family became alarmed when she had
extreme bouts of chills and fever that did not respond to aspirin or Tylenol. She was
brought to the emergency department where blood samples were collected for both
thin and tick smears. What would be the probable species of parasite involved in this
medical condition?
2. Just before the fall semester began, two college sophomores from Connecticut
decided to take a last break before beginning the rigors of study. After camping for
a few days along the New England coast, they returned home to pack for a return to
college. Two weeks after returning to college, both of the friends began suffering
from a mild fever and headaches which were accompanied by fatigue. They had both
heard of mononucleosis and made appointments at the student health center for
potential treatment. Blood smears revealed intracellular inclusions that resembled
malaria. What was the probable infective organism?
3. During the Desert Storm conflict, a number of National Guardsmen were deployed
to northern Saudi Arabia and southern Iraq. They were issued an insect repellent but
were eventually told not to use the material as it may be carcinogenic. Most of them
reported numerous bites by sandflies, and a number of them had vague medical
complaints upon returning to the United States, including sores on the skin, some of
which extended into the subcutaneous tissues. With what condition would soldiers
with these symptoms most likely be diagnosed?
4. After completing a veterinary assistant program, Julie obtained a position with a local
veterinarian. The small animal practice involved a larger number of cats as patients.
When Julie became pregnant, her obstetrician seemed concerned about her position
where she had contact with cats, in particular. On what are his concerns founded?
5. A church group of college-age students from the southern United States organized a
trip to Brazil. The purpose of the trip was to educate the natives of a remote village in
the heavy forests of the country in matters of health and sanitation. Upon arrival, the
group found no adequate housing, but a number of mud-walled thatched huts were
empty and available for the two-week stay. Most of the meals were eaten outside as
there were a number of insects with elongated bodies that could be easily seen near
the tops of the mud walls. After a few nights, most of the students had reddened
and itchy areas near the mouth, nose, and eyes. A topical ointment relieved most
of the symptoms, but advanced medical care was not available in the village or even
nearby. Shortly after returning to their homes, a number of those who had been on
the trip to Brazil began to experience chills and fever. These symptoms were accom-
panied by glandular enlargement and a rash on the abdomen. Some complained of
malaise and myalgia (muscle aches). One of the members of the church, a physician,
suggested blood tests for all of those involved with the trip. What would be the most
likely diagnosis obtained from these tests?
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