Plasmodium Vivax

This was a case of Plasmodium Vivax although Ovale is also a good call:

• A. Trophozite – often multiply infected with large chromatin dots
• B. Trophozite – Schuffner dot’s can be seen (in Gimesa stained films)
• C. Schizont – 12-14 merozites clustered around dark brown pigment
• D. Gemetocyte – large and fill the cell, pigmented with coarse brown pigment, a microgematocyte is shown due to the diffuse pigment

It can be very difficult, sometimes impossible to distinguish with P ovale but some clues:

• More Schuffner dot’s in ovale
• Fimbriated red cells in ovale
• Less merozoites seen in ovale and arranged irregulary (bunch of grapes)
• Travel history – vivax: tropics, ovale: West Africa 

Don’t forget to look for P. falciparum infection, the 2 can co-exist!

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