Blood Smears Research Articles

Case of vector-borne coinfection in a dog

Vector-borne diseases (VBD) in dogs, such as babesiosis, ehrlichiosis, anaplasmosis, and dirofilariasis, pose a significant threat to animal health in many regions worldwide, including Ukraine. These diseases are transmitted through the bites of ectoparasites, such as ticks and mosquitoes. With increasing urbanization, climate change, and population migration, the risk of spreading these diseases is significantly heightened. This article is dedicated to the case analysis of a dog in Ukraine diagnosed with two vector-borne diseases simultaneously, focusing on the clinical manifestations and diagnostic approaches for these conditions. Currently, the prevalence of VBD in dogs in Ukraine is insufficiently studied. There are only sporadic reports of isolated pathogens, with comprehensive information needing to be included. A case of concurrent dirofilariasis and babesiosis in a dog is presented. In the spring of 2024, an 8-year-old intact male German shepherd was brought to a veterinary clinic in Kamianets-Podilskyi due to general weakness. Clinical signs included fever, vomiting, slightly pale mucous membranes, and a mild cough. Following abdominal ultrasound and blood sample collection, anti-inflammatory and antiemetic medications were prescribed. A blood smear revealed Babesia canis and treatment with imidocarb was initiated. However, after a week, the dog's condition did not improve. A repeat blood test detected live microfilariae, and the CaniV-4 test identified antibodies to D. immitis, confirming dirofilariasis. Molecular studies corroborated the diagnosis. Follow-up echocardiography and radiography did not reveal visible adult worms in the heart. The dog was treated with melarsomine and a combination of imidacloprid and moxidectin. Two months later, follow-up blood tests showed no presence of microfilariae, and all blood and biochemical parameters were within normal ranges. The dog was under continuous veterinary supervision for the following months. Overall, there is a noticeable trend in the increase of VBD among dogs in Ukraine, necessitating heightened attention from veterinary services and pet owners. Regular preventive measures, such as ectoparasite control and health monitoring, are crucial for managing the spread of these diseases.

Efficacy and safety of emodepside compared with albendazole in adolescents and adults with hookworm infection in Pemba Island, Tanzania: a double-blind, superiority, phase 2b, randomised controlled trial

Human hookworm is a cause of enormous global morbidity. Current treatments have insufficient efficacy and their extensive and indiscriminate distribution could also result in drug resistance. Therefore, we tested the efficacy and safety of emodepside, a strong anthelmintic candidate that is currently undergoing clinical development for onchocerciasis and soil-transmitted helminth infections. We conducted a double-blind, superiority, phase 2b, randomised controlled clinical trial comparing emodepside and albendazole. Participants in the emodepside group received six 5 mg tablets of emodepside (totalling 30 mg) and one placebo; participants in the albendazole group received one 400 mg tablet of albendazole and six placebos. Participants were recruited from four endemic villages and three secondary schools in Pemba Island, Tanzania. Participants aged 12-60 years were eligible for treatment if they were positive for hookworm infection, and they had 48 or more eggs per gram from four Kato-Katz thick smears and at least two slides had more than one hookworm egg present. Participants' treatment allocation was stratified by infection intensity and efficacy was measured by cure rate: participants who were hookworm positive and became hookworm negative after treatment. Adverse events were reported at 3 h, 24 h, 48 h, and 14-21 days post-treatment. The trial is registered at ClinicalTrials.gov, NCT05538767. From Sept 15 to Nov 8, 2022, and from Feb 15 to March 15, 2023, 1609 individuals were screened for hookworm. Of these, 293 individuals were treated: 147 with albendazole and 146 with emodepside. Emodepside demonstrated superiority, with an observed cure rate against hookworm of 96·6%, which was significantly higher compared with albendazole (cure rate 81·2%, odds ratio 0·14, 95% CI 0·04-0·35; p=0·0001). The most common adverse event in the emodepside treatment group was vision blur at 3 h after treatment (57 [39%] of 146). Other common adverse events were vision blur at 24 h after treatment (55 [38%]), and headache and dizziness at 3 h after treatment (55 [38%] for headache and 43 [30%] for dizziness). In the emodepside treatment group, 298 (93%) of the 319 adverse events were mild. The most commonly reported adverse events in the albendazole treatment group were headache and dizziness at 3 h after treatment (27 [18%] of 147 for headache and 14 [10%] for dizziness). No serious adverse events were reported. This phase 2b clinical trial confirms the high efficacy of emodepside against hookworm infections, solidifying emodepside as a promising anthelmintic candidate. However, although the observed safety events were generally mild in severity, considerations must be made to balance the strong efficacy outcomes with the increased frequency of adverse events compared with albendazole. European Research Council.

A Comparative Study of Peripheral Smear Findings with RBC Indices and Automated Analyzer Generated RBC Histograms in the Diagnosis of Anemia's

Abstract Introduction The red blood cell (RBC) indices generated by cell counters help in the morphological classification of anemia. The importance of microscopic examination of peripheral blood smears (PBSs) stained by Leishman stain cannot be used alone when it comes to interpretation of the underlying cause of anemia. Hence, all three RBC histograms, indices, and microscopic examination of PBSs are very essential for a complete assessment of anemia. Aims and Objectives To diagnose the type of anemia by examination of PBSs, automated cell-generated RBC histograms, and RBC indices and to compare and correlate the findings of RBC indices and automated cell-generated RBC histograms with PBS examination. Materials and Methods This was a prospective comparative study done on 500 cases of anemia for a period of 5 months from August 2023 to December 2023 in a rural tertiary care teaching hospital and all the patients' RBC indices, RBC histogram findings, and PBS findings were noted and analyzed. Results Among 500 samples, normocytic normochromic anemia consists of the majority of the cases 272 (54.4%), followed by microcytic hypochromic anemia cases 183 (36.6%), macrocytic anemia cases 27 (5.4%), normocytic hypochromic anemia were 10 (2%) cases, and dimorphic were 8 cases (1.6%). When compared with RBC histogram, 265 (53.0%) cases showed normal bell-shaped curve, 188 (37.6%) cases showed left shift, 27 (5.4%) cases showed broad based curve, 10 (2%) cases showed right shift, and 10 (2%) cases showed bimodal curve suggesting normocytic normochromic, microcytic hypochromic, normocytic hypochromic anemia, macrocytic, and dimorphic anemia, respectively. Conclusion This study showed a well correlation in the findings of the automated hematology analyzer with the microscopic examination. Histogram alone could be used as a screening method but when combined with RBC indices and PBS findings, they act as useful supplements and by correlating findings of all three, we could diagnose the majority of anemia.

Molecular Diagnosis of Mycoplasma haemofelis and ‘Candidatus Mycoplasma haemominutum’ in Domestic Feline: A Case Report

The aim of this work was to report the molecular diagnosis of Mycoplasma haemofelis and 'Candidatus Mycoplasma haemominutum' in a domestic feline. Mycoplasma spp. are pleomorphic bacteria that parasitize the surface of red blood cells in several domestic species, mainly cats, being responsible for feline mycoplasmosis, which can cause hemolytic anemia. Cats can become infected through blood transfusions, social interactions via fights and flea bites. In this report, the patient exhibited in the clinical exam, pale and icteric mucous membranes, and enlargement of the popliteal and submandibular lymph nodes. Based on the symptoms presented, a blood sample was collected to search for hemoparasites using blood smears and also molecular examination by polymerase chain reaction (PCR). The blood smear revealed inclusions characteristic of Mycoplasma spp. Observed in red blood cells, and the diagnosis of mycoplasmosis was confirmed by PCR. This report highlights the importance of screening for hemoparasites in the feline clinical routine, with molecular tests being the most recommended due to their high sensitivity and specificity.

The Unusual Presentation of Bilateral Proptosis Presents a Dilemma in the Case of Juvenile Myelomonocytic Leukemia

AbstractJuvenile myelomonocytic leukemia (JMML) is a myelodysplastic/myeloproliferative neoplasm. It is a rare pediatric neoplasm occurring in early childhood. Herein, we present a case of JMML in a 4-year-old girl admitted for primary complaints of protrusion of eyes and fever for the past 15 days not responding to any medications. With findings of splenomegaly and peripheral blood smear showing severe leukocytosis and increased monocytoid and blast cells, a myelomonocytic series neoplasm was suspected. Abelson (Abl) tyrosine kinase gene break point cluster (Bcr) gene (BCR-ABL1) was found to be negative on fluorescence in situ hybridization (FISH). Taking into consider all these findings, the patient was diagnosed with JMML. Since hematopoietic stem cell transplantation (HSCT) is not offered at our hospital, the patient was referred to another medical facility for the required procedure. This case highlights that bilateral proptosis could be a primary finding in early cases of JMML and should not be missed.

Cytauxzoon brasiliensis sp. nov. (Apicomplexa: Theileriidae), a new species infecting a little-spotted-cat (Leopardus tigrinus) (Carnivora: Felidae) from Brazil.

Cytauxzoon spp. have been detected in Brazil infecting mainly asymptomatic domestic cats and wild felids. However, the supposed genetic similarity with the pathogenic Cytauxzoon felis is questionable because it is based on analysis of short sequences of the 18S rRNA gene. Herein, we describe a novel Cytauxzoon species infecting an asymptomatic little-spotted-cat (Leopardus tigrinus) based on morphological, histopathological, and molecular analyses. The animal was attended presenting a history of a run-over with multiple traumas. Although the little-spotted-cat was stabilized, he died a few days later. Ring-shaped merozoites within erythrocytes were found on blood smears and in the abdominal effusion. In addition, schizonts were observed in histiocytes in the liver. Phylogenetic analyses based on both near-complete 18S rRNA and cytb genes positioned the obtained sequences in a unique clade, albeit closely related to Cytauxzoon felis from the USA. Genetic divergences ranging from 0.004 and 0.067-0.068 were found between the near-complete 18S rRNA and cytb sequences of Cytauxzoon sp. detected in the little-spotted-cat and C. felis, respectively. This study evidenced the circulation of a novel Cytauxzoon species, herein named Cytauxzoon brasiliensis sp. nov., in an asymptomatic wild felid species from Brazil. Further studies are necessary to identify Cytauxzoon species from domestic and wild felids in the country.

The Uganda housing modification study - association between housing characteristics and malaria burden in a moderate to high transmission setting in Uganda

BackgroundScale up of proven malaria control interventions has not been sufficient to control malaria in Uganda, emphasizing the need to explore innovative new approaches. Improved housing is one such promising strategy. This paper describes housing characteristics and their association with malaria burden in a moderate to high transmission setting in Uganda.MethodsBetween October and November 2021, a household survey was conducted in 1500 randomly selected households in Jinja and Luuka districts. Information on demographics, housing characteristics, use of malaria prevention measures, and proxy indicators of wealth were collected for each household. A finger-prick blood sample was obtained for thick blood smears for malaria from all children aged 6 months to 14 years in the surveyed households. Febrile children had a malaria rapid diagnostics test (RDT) done; positive cases were managed according to national treatment guidelines. Haemoglobin was assessed in children aged < 5 years. Households were stratified as having modern houses (defined as having finished materials for roofs, walls, and floors and closed eaves) or traditional houses (those not meeting the definition of modern house). Associations between malaria burden and house type were estimated using mixed effects models and adjusted for age, wealth, and bed net use.ResultsMost (65.5%) of the households surveyed lived in traditional houses. Most of the houses had closed eaves (85.5%), however, the use of other protective features like window/vent screens and installed ceilings was limited (0.4% had screened windows, 2.8% had screened air vents, and 5.2% had ceiling). Overall, 3,443 children were included in the clinical survey, of which 31.4% had a positive smear. RDT test positivity rate was 56.6% among children with fever. Participants living in modern houses had a significantly lower parasite prevalence by microscopy (adjusted prevalence ratio [aPR = 0.80]; 95% confidence interval [CI] 0.71 – 0.90), RDT test positivity rate (aPR = 0.90, 95%CI 0.81 – 0.99), and anaemia (aPR = 0.80, 95%CI 0.65 – 0.97) compared to those in traditional houses.ConclusionThe study found that even after adjusting for wealth, higher quality housing had a moderate protective effect against malaria, on top of the protection already afforded by recently distributed nets.

Biophysical profiling of red blood cells from thin-film blood smears using deep learning

Microscopic inspection of thin-film blood smears is widely used to identify red blood cell (RBC) pathologies, including malaria parasitism and hemoglobinopathies, such as sickle cell disease and thalassemia. Emerging research indicates that non-pathologic changes in RBCs can also be detected in images, such as deformability and morphological changes resulting from the storage lesion. In transfusion medicine, cell deformability is a potential biomarker for the quality of donated RBCs. However, a major impediment to the clinical translation of this biomarker is the difficulty associated with performing this measurement. To address this challenge, we developed an approach for biophysical profiling of RBCs based on cell images in thin-film blood smears. We hypothesize that subtle cellular changes are evident in blood smear images, but this information is inaccessible to human expert labellers. To test this hypothesis, we developed a deep learning strategy to analyze Giemsa-stained blood smears to assess the subtle morphologies indicative of RBC deformability and storage-based degradation. Specifically, we prepared thin-film blood smears from 27 RBC samples (9 donors evaluated at 3 storage time points) and imaged them using high-resolution microscopy. Using this dataset, we trained a convolutional neural network to evaluate image-based morphological features related to cell deformability. The prediction of donor deformability is strongly correlated to the microfluidic scores and can be used to categorize images into specific deformability groups with high accuracy. We also used this model to evaluate differences in RBC morphology resulting from cold storage. Together, our results demonstrate that deep learning models can detect subtle cellular morphology differences resulting from deformability and cold storage. This result suggests the potential to assess donor blood quality from thin-film blood smears, which can be acquired ubiquitously in clinical workflows.

Blood Cancer Identification on Peripheral Blood Smear (PBS) Images Using HSV Feature Extraction

Blood cancer is a category of diseases that have an impact on the development and operation of blood cells. Due to the complexity and diversity of these diseases, proper diagnosis is required before starting treatment. Medical imaging techniques have undergone significant advances in recent years, especially in peripheral blood smear (PBS) image processing. The aim of this study was to uncover how important the extraction of PBS image features is for the diagnosis of blood cancer. Feature extraction is essential to detect anomalies in blood cells in terms of blood cancer detection. The method used is feature extraction based on hue and saturation values (HSV) and uses Machine Support Vector Machine (SVM) machine learning algorithms in classifying malignant and benign PBS images. PBS image data used in this study was 100 images, consisting of 50 malignant PBS images, and 50 benign PBS images. Through the application of HSV feature extraction techniques and PBS image analysis, SVM algorithms can uncover latent indicators of blood cancer and facilitate timely and precise diagnosis. With the SVM technique, classification accuracy can be achieved by 92%. These results demonstrate the potential effectiveness of this feature extraction method. Extraction of HSV features may alter the diagnosis of blood cancer with additional research and application in clinical settings.

A genome-based investigation of the Priestia species isolated from anthrax endemic regions in Kruger National Park

Priestia is a genus that was renamed from the genus Bacillus based on the conserved signature indels (CSIs) in protein sequences that separate Priestia species from Bacillus, with the latter only including species closely related to B. subtilis and B. cereus. Diagnosis of anthrax, a zoonotic disease, is implicated by tripartite anthrax virulence genes (lef, pagA, and cya) and poly-γ-D-glutamic acid capsular genes cap-ABCDE of Bacillus anthracis. Due to the amplification of anthrax virulence genes in Priestia isolates, the search for homologous anthrax virulence genes within the Priestia genomes (n = 9) isolated from animal blood smears was embarked upon through whole genome sequencing. In silico taxonomic identification of the isolates was conducted using genome taxonomy database (GTDB), average nucleotide identity (ANI), and multi-locus sequence typing (MLST), which identified the genomes as P. aryabhattai (n = 5), P. endophytica (n = 2) and P. megaterium (n = 2). A pan-genome analysis was further conducted on the Priestia genomes, including the screening of virulence, antibiotic resistance genes and mobile genetic elements on the sequenced genomes. The oligoribonuclease NrnB protein sequences showed that Priestia spp. possess a unique CSI that is absent in other Bacillus species. Furthermore, the CSI in P. endophytica is unique from other Priestia spp. Pan-genomic analysis indicates that P. endophytica clusters separately from P. aryabhattai and P. megaterium. In silico BLASTn genome analysis using the SYBR primers, Taqman probes and primers that target the chromosomal marker (Ba-1), protective antigen (pagA), and lethal factor (lef) on B. anthracis, showed partial binding to Priestia regions encoding for hypothetical proteins, pyridoxine biosynthesis, hydrolase, and inhibitory proteins. The antibiotic resistance genes (ARG) profile of Priestia spp. showed that the genomes contained no more than two ARGs. This included genes conferring resistance to rifamycin and fosfomycin on P. endophytica, as well as clindamycin on P. aryabhattai and P. megaterium. Priestia genomes lacked B. anthracis plasmids and consisted of plasmid replicon types with unknown functions. Furthermore, the amplification of Priestia strains may result in false positives when qPCR is used to detect the virulence genes of B. anthracis in soil, blood smears, and/or environmental samples.

Robustness assessment of an automated AI-based white blood cell morphometric analysis system using different smear preparation methods.

Numerous AI-based systems are being developed to evaluate peripheral blood (PB) smears, but the feasibility of these systems on different smear preparation methods has not been fully understood. In this study, we assessed the impact of different smear preparation methods on the robustness of the deep learning system (DLS). We collected 193 PB samples from patients, preparing a pair of smears for each sample using two systems: (1) SP50 smears, prepared by the DLS recommended fully automated slide preparation with double fan drying and staining (May-Grunwald Giemsa, M-G) system using SP50 (Sysmex) and (2) SP1000i smears, prepared by automated smear preparation with single fan drying by SP1000i (Sysmex) and manually stained with M-G. Digital images of PB cells were captured using DI-60 (Sysmex), and the DLS performed cell classification. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were used to evaluate the performance of the DLS. The specificity and NPV for all cell types were 97.4%-100% in both smear sets. The average sensitivity and PPV were 88.9% and 90.1% on SP50 smears, and 87.0% and 83.2% on SP1000i smears, respectively. The lower performance on SP1000i smears was attributed to the intra-lineage misclassification of neutrophil precursors and inter-lineage misclassification of lymphocytes. The DLS demonstrated consistent performance in specificity and NPV for smears prepared by a system different from the recommended method. Our results suggest that applying an automated smear preparation system optimized for the DLS system may be important.

Detection through the use of RT-MqPCR of asymptomatic reservoirs of malaria in samples of patients from the indigenous Comarca of Guna Yala, Panama: Essential method to achieve the elimination of malaria.

Plasmodium vivax is the main causative agent of malaria in Panama. However, the prevalence of asymptomatic infections in the different endemic regions remains unknown. Understanding the epidemiological behavior of asymptomatic infections is essential for the elimination of malaria. This study aimed to determine the prevalence of asymptomatic malarial infections in one of the main endemic regions of Panama using multiplex real-time reverse transcription RT-MqPCR. A cross-sectional study was conducted in three communities in the Guna Yala Comarca. A total of 551 thick blood smears and their respective samples on filter paper were collected from volunteers of different ages and sexes from June 20 to 25, 2016. Infections by the Plasmodium spp. were diagnosed using microscopy and RT-MqPCR. All statistical analyses were performed using the R software. The average prevalence of asymptomatic infections by P. vivax in the three communities detected by RT-MqPCR was 9.3%, with Ukupa having the highest prevalence (13.4%), followed by Aidirgandi (11.1%) and Irgandi (3.3%). A total of 74 samples were diagnosed as asymptomatic infections using RT-MqPCR. Light microscopy (LM) detected that 17.6% (13/74) of the asymptomatic samples and 82.4% (61/74) were diagnosed as false negatives. A 100% correlation was observed between samples diagnosed using LM and RT-MqPCR. A total of 52.7% (39/74) of the asymptomatic patients were female and 85.1% (63/74) were registered between the ages of 1 and 21 years. Factors associated with asymptomatic infection were community (aOR = 0.38 (95% CI 0.17-0.83), p < 0.001) and age aOR = 0.98 (95% CI 0.97-1.00), p < 0.05); F = 5.38; p < 0.05). This study provides novel evidence of the considerable prevalence of asymptomatic P. vivax infections in the endemic region of Kuna Yala, representing a new challenge that requires immediate attention from the National Malaria Program. The results of this study provide essential information for the health authorities responsible for developing new policies. Furthermore, it will allow program administrators to reorient and design effective malaria control strategies that consider asymptomatic infections as a fundamental part of malaria control and move towards fulfilling their commitment to eliminate it.

Chronic myeloid leukemia in an ulcerative colitis patient receiving azathioprine: A case report.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease usually treated by azathioprine. It is a well-established risk factor for colorectal cancers and extraintestinal malignancies. Nevertheless, the risk of myeloid leukemia in patients with UC is less known. We report a case of a 51-year-old patient, with a history of extensive ulcerative colitis, who was treated with azathioprine at a dose of 2.5 mg/kg/day. Seven years later, he presented an increased count of white blood cells at 25,400/μL and of platelets at 1,382,000/μL. Peripheral blood smear showed 1% blasts and 20% myelemia. The karyotype showed the Philadelphia chromosome and the RT-PCR revealed the BCR-ABL transcript. Thus, chronic myeloid leukemia (CML) was confirmed and imatinib was prescribed. This case reported a rare and serious event in a UC patient and illustrates the importance of closely monitoring this population.

Epidemiology of Canine Ehrlichiosis in Jabalpur Region of Madhya Pradesh, India

Numerous plant and animal species that are either directly or indirectly linked to tick-borne haemo-protozoan infections thrive in the tropical and subtropical climates of the Indian subcontinents. The climate in India is home to the brown dog tick or Rhipicephalus sanguineus, which is a carrier of the canine disease Ehrlichia. The main purpose of the study is to explore the prevalence and their risk factors associated with Canine Ehrlichiosis. For this 422 canines suspected for positive ehrlichiosis was examined through Giemsa stained thin blood smear and out of them 25 canine samples were found positive showed incidence rate of 5.92%. Prevalence of ehrlichiosis was more in summer season when compare in to winter and monsoon which might be due to high activity of tick vectors. Younger and male dogs showed higher prevalence in comparison to older and female canines. The clinical signs were tick infestation (96%), lymphadenopathy (80%), anorexia (76%), pyrexia (72%), anaemia (56%) and pale conjunctival mucous membrane (56%) along with epistaxis, lameness and ocular problem. This study identifies the present scenario and associated risk factors of the disease, which may help to reduce the infection of canine ehrlichiosis.

Evaluating pathologist practices in peripheral blood smear review: A comprehensive practice survey.

Widely accepted standardized criteria for peripheral blood (PB) smear review do not exist. The aim of this study was to collect data regarding PB smear review practices across multiple institutions, with a focus on pathologist review. A 23-question survey was developed by members of the Society for Hematopathology (SH) Education Committee and distributed to SH members. The survey included questions on practice environment and PB smear review practices, including trainee involvement. Of 725 members contacted, 137 (19%) completed the entire survey. Over half of practices examined 5 to 20 smears a day. All respondents reported using complete blood count/differential leukocyte count data and clinical history as part of smear review. The reported proportion of laboratory-initiated vs clinician-requested reviews varied across respondents. Clinician-requested smear reviews were more likely to be billed and issued as a separate pathology report. Glass slide review (as opposed to digital microscopy) was used by most respondents. All respondents affirmed that PB smear review is an essential component of pathology training programs. Numerous free-text comments were submitted by respondents regarding their own experiences with PB smear review and suggested improvements. This survey elucidated the spectrum of practice patterns for pathologist review of blood smears and identified potential areas for process improvement.

Iatrogenic transmission of Trypanosoma evansi infection in camels and its consequences

Trypanosoma evansi infection has started to become a wide spread phenomena around the camel-rearing areas of North Africa and the Middle East. The disease caused by trypanosomes is locally known as “Surra” and it can seriously impact not only the health of domestic animals but the local economy as well. After taking over the management of a farm containing approximately 700 camels, it was found that a large number were suffering from trypanosome infection and it was of the utmost importance to find the source of this infection. An extensive dive into the records and observations were initially made to identify the infected population. Under closer inspection it was found that the infection was limited mostly to female individuals that had undergone extended reproductive analysis or treatment. Blood samples were taken from each of the individuals for buffy coat test and blood smears. Among the total number of tested camels (n = 590), almost 40% were infected with trypanosomes. The number and percentage of infection correlate with the number of fertility and pregnancy treatments that the camels had undergone. The most severely infected group, underwent between 17 and 20 instances of treatment or tests, had an infection rate of almost 90%. The devastating effect of trypanosomiasis on camel pregnancy and birth were also verified with 61% of all abortions and 82% of all neonatal deaths coming from trypanosome infected individuals. These results clearly demonstrate how damaging iatrogenic infections of T. evansi can be and how simply they could have been prevented.

MDS-Type Morphologic Abnormalities of Peripheral Blood Granulocytes in Symptomatic COVID-19 Patients.

Background: Hematological abnormalities in COVID-19 infection included quantitative and qualitative changes and should be further characterized. Evaluation for myelodysplastic syndromes (MDS) is usually prompted by abnormal hematologic findings and the presence of dysplastic morphologies. Viral infections are considered to be the cause of dysplastic morphologies and should be considered by morphologists. There are few reports of dysplastic abnormal morphologies in patients with COVID-19 infection. However, such correlations still have to be clarified. Materials and Methods: In the present study, we examined the granulocyte lineage morphological abnormalities in symptomatic RT-PCR-confirmed COVID patients. Peripheral blood samples were collected from 82 patients with symptomatic COVID-19. Blood smears were prepared according to the standard Wright-Giemsa staining procedure. The morphological examination was carried out by two laboratory experts. Results: Blood smear examination revealed common myelodysplastic syndrome (MDS) type abnormalities including but not limited to pseudo-pelger nuclear lobulation (4.8%), hypogranulation (7.3%), Howell-Jolly-like bodies or detached nuclear segments (6.0%) and elongated and thin nuclear filaments (6.0%). One case of abnormal immature granulocyte and ring form nucleus is also evident. Conclusion: Our results accounted for the possibility of active COVID-19 infection in all subjects with granulocyte dysplasia. These results are of practical importance for patients suspected of having myelodysplastic syndromes or disease processes associated with myeloid malignancies.

Developmental stages and molecular phylogeny of Hepatozoon fitzsimonsi (Dias 1953) (Adeleorina: Hepatozoidae) in tortoises Stigmochelys pardalis (Cryptodira: Testudinidae) and ticks of the genus Amblyomma (Acari: Ixodidae) from South Africa

BackgroundHepatozoon fitzsimonsi (Dias, 1953) is a frequently found haemogregarine of southern African tortoises. At the time of this species’ reassignment from the genus Haemogregarina to Hepatozoon, developmental stages such as sporocysts and sporozoites were observed in ticks associated with H. fitzsimonsi parasitised and non-parasitised tortoises. It was thus suggested that ticks may act as the potential vectors for this parasite. However, this earlier research was unable to confirm the identity of these sporogonic stages using molecular markers. In a separate study aimed at identifying tick species parasitising South African reptiles and molecularly screening these for the presence of Hepatozoon, that study identified H. fitzsimonsi in tortoise-associated ticks. Thus, the present study aimed to revisit the potential of ticks to act as vectors for H. fitzsimonsi in tortoises using a combined microscopy and molecular approach.MethodsSpecimens of Kinixys natalensis, Kinixys spekii, Kinixys zombensis and Stigmochelys pardalis were collected from Bonamanzi and Ndumo Game Reserve, South Africa. Upon capture, animals were examined for ticks, and these were collected along with blood and other tissues. Adult ticks were dissected and visceral impression slides were prepared along with thin blood and tissue smears on clean microscope slides. Smears and impression slides were stained with Giemsa, screened and micrographs of parasites were captured. Two primer sets were employed to target fragments of the 18S rRNA gene of parasites found in both tortoises and ticks and the resulting sequences were then compared with other known H. fitzsimonsi and haemogregarine sequences from the GenBank database.ResultsPeripheral blood gamont and liver merogonic stages were observed in S. pardalis, while the sporogonic stages were observed in the haemocoel of Amblyomma ticks. Gamont and sporocyst stages compared morphologically with previous descriptions of H. fitzsimonsi, identifying them as this species. Phylogenetic analysis revealed that the blood and tick sequences obtained in this study clustered in a monophyletic clade comprising known H. fitzsimonsi.ConclusionsThe present study provides further support for ticks acting as the vectors of H. fitzsimonsi by molecularly identifying and linking observed developmental stages in tortoises (S. pardalis) with those in the invertebrate host (Amblyomma spp.).Graphical

Genotoxic effects in blood cells of sturger (Acipenseridae) grown in conditions of cage farming of the Volga delta, Russia

The purpose of this work was to assess the degree of genotoxic influence of the habitat on individuals of Russian sturgeon and sterlet raised in cage farming conditions in the Volga delta, using micronucleus and DNA comet tests.The blood of the individual Russian sturgeon and sterlet was shaved off during their lifetime. A comet DNA test was performed using the alkaline method. The number of erythrocytes with micronuclei was determined microscopically. To assess the physiological state of sturgeons, conventional hematological and biochemical methods were used.In the samples of fish blood smears studied, the average proportion of erythrocytes with micronuclei was 3.20 ± 1.24 ‰ in Russian sturgeon and 5.25 ± 1.18 ‰ in sterlet. The proportion of DNA in the comet tail in erythrocytes of Russian sturgeon was 3,99 %, and in sterlet 6, 48 %. The values of tail moment and Olivet moment were also lower in Russian sturgeon. Among sterlet erythrocytes, a more heterogeneous pattern of DNA damage can be noted. The length of the comet tail in starlet individuals turned out to be lower than in Russian sturgeon: apparently, larger fragments of these molecules were formed when the DNA of starlet erythrocytes was damaged. The physiological state of sterlet individuals can be characterised as normal, and that of the Russian sturgeon as satisfactory, due to the deviations identified in the values of some hematological and biochemical blood parameters.Having studied the influence of the environment on individual sturgeon kept in cage aquaculture conditions in the Volga delta using micronuclear and DNA comet tests, we can conclude that there was no acute genotoxic effect at the time of the study.

A Retrospective Longitudinal Study of Refugees With Eosinophilia at an Academic Center in the United States From 2015 to 2020.

Refugees to the United States frequently have parasitic infections. If untreated, parasites can cause severe complications. The purpose of this study was to investigate the incidence, management, and outcomes of eosinophilia as a biomarker for parasites. We conducted a retrospective longitudinal chart review of consecutive refugees attending 3 refugee clinics in Rhode Island that manage the health care of all pediatric and adult refugees. Among 812 refugees who met inclusion criteria, 147 (18.1%) had eosinophilia upon arrival and almost half had ≥1 symptom. The rates and severity of eosinophilia in those with predeparture presumptive treatment records who did (112/115, 97.4%) or did not (488/498, 98.0%) receive predeparture antiparasitic treatment were similar. All refugees with eosinophilia had ≥1 parasitic test in the United States. The most common attributable parasites were Schistosoma and Strongyloides stercoralis. Overall, parasites were detected in 63 (42.9%) of 147 refugees with eosinophilia by either stool testing, serology, or blood smear, but testing was inconsistent and likely underestimated true incidence. Only some of the identified parasites typically cause eosinophilia. Forty-five (30.6%) refugees with eosinophilia received antiparasitics in the United States. Of 81 (55.1%) individuals who had repeat blood tests, eosinophilia had resolved in 52 (64.2%). Five individuals (3.4%) had alternative diagnoses, including eczema, myelofibrosis, and drug allergy. Our findings support Centers for Disease Control and Prevention recommendations to screen for eosinophilia in newly arrived refugees. Follow-up after 3-6 months is critical to confirm resolution of residual eosinophilia, which frequently occurs after effective predeparture treatment or if eosinophilia persists, to diagnose active parasitic infections.