I am presenting a series of images from blood smears from my in house lab. I find this to be a truly remarkable image.
I have treated this patient for severe, relenting disease for a period of two years. She is on a second round of IV antibiotics. Progress has been slow. Night sweats, nightly fevers, air hunger, headaches and muscle pain have been prominent, persisting symptoms. She consistently tested negative for B. microti and B. duncani until recently. She now has a high titer of antibodies for WA1 or Babesia duncani after numerous rounds of anti-malaria therapies. I am not sure she has B. duncani. I think she may be infected with a cross-reacting species. This sero-conversion as more commonly seen in Lyme Western Blots. She has failed every regimen for Babesia. This smear was obtained which she is on IV clindamycin and quinine (which she tolerates well). This smear shows a typical Babesia "bowtie." This image was obtained from a fresh smear stained with Wright Giemsa.