ASM CPHMC Case Study Malfeasance in the Bloodstream

Case study

1. Gerald A. Capraro , Ph.D., D(ABMM ) Louisiana State University Health Sciences Center “ Mal”feasance in the Bloodstream

2. Patient History 29 month old female from Togo, a small country of the West Coast of Africa. Emigrated to US with parents (father US military) about 2 weeks ago (mid-July). Treated for malaria (treatment unknown, species unknown) about 3 months prior.

3. Fever in a returning traveler Bacterial. Salmonella typhi . Rickettsial diseases. Viral. Yellow Fever. Dengue Fever. Parasites. Malaria.

4. Testing for M alaria A tube of blood is collected and sent to the laboratory The blood is put onto a microscope slide, stained and a microbiologist looks at the blood smear under a microscope to detect RBCs infected with parasites

5. Multiply infected RBC Photo Credit: LSU Health- Shreveport

6. Malaria Caused by several species of the Plasmodium genus of parasites. Plasmodium parasites are transmitted through the bite of an infected mosquito. 1,500 new cases of malaria are reported in the US each year – nearly all of them in returning travelers. For more information visit www.cdc.gov/malaria .

7. Anopheles Mosquito Pumping Blood Photo Credit: Centers for Disease Control and Prevention

8. Photo Credit: Centers for Disease Control and Prevention

9. Resolution The patient was treated with quinidine and clindamycin for 2 days followed by malarone for 3 days and recovered.

10. Gerald A. Capraro , Ph.D., D(ABMM ) Photo Credit: Gerald A. Capraro. Ph.D., D(ABMM ) Dr. Capraro is an Assistant Professor at the Louisiana State University Health Sciences Center in Shreveport, Department of Pathology, and the Medical Director of the Clinical Microbiology and Diagnostic Virology Laboratories at University Health - Shreveport. Dr. Capraro is a Diplomate of the American Board of Medical Microbiology and has expertise spanning the breadth of medical and public health microbiology, including bacteriology, mycobacteriology, virology, mycology, parasitology, and infectious disease serology. Dr. Capraro’s research interests include molecular mechanisms of antibiotic resistance and microbial virulence, and the development of molecular diagnostic assays for use in the clinical laboratory, particularly with regard to their impact on patient care outcomes and healthcare costs.