Plasmodium falciparum

By : Tharsini a/p Salyam

Mengetahui morfologi parasit Plasmodium falciparum dalam filem darah tebal dan filem darah nipisMengenal pasti dan melukis morfologi parasit Plasmodium falciparumMengetahui perubahan ke atas sel perumah sel darah merah dari segi saiz , bentuk dan kehadiran bintik bintik untuk parasit Plasmodium falciparum

INTRODUCTION

• Total known species 5 : P.falciparum P.ovale

P.malariae P.vivax P.knowlesi• Transmission : mosquito , blood

tranfusion, placenta and lab accidents

Malaria Diagnosis

Blood Smear Prepare smears as soon as possible after collecting venous blood to avoid any Changes in parasite morphology.

the “gold standard”“gold standard” for diagnosis of malaria..

B.F.F.M.=Blood Film For Malaria

Reporting of Blood film

Look for the different morphological forms of parasite in blood smear:

1. Trophozoites / ring forms2. Schizont 3. Gametocytes

Identify species – differences in the characteristics of morphological forms in different species

Recognizing Malaria Parasites

Inside a red blood cell

One or more red chromatin dots

Blue cytoplasm

RING TROPHOZOITE

SCHIZONT GAMETOCYTE

BlueCytoplasm

RedChromatin

BrownPigment

Recognizing Erythrocytic Stages:Schematic Morphology

Recognizing Erythrocytic Stages:RBC CHARACTERISTICS Plasmodium falciparum

Size Mature RBC

Color Normal

Shape Round . Maybe crenated

Cytoplasmic inclusion Maurer’s cleft maybe present in late trophozoite

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1

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22

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1: Small trophozoites.2: Gametocytes — normal.3: Slightly distorted gametocyte.4: “Rounded-up” gametocyte.5: Disintegrated gametocyte.6: Nucleus of leucocyte.7: Blood platelets.8: Cellular remains of young erythrocyte.

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1

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THICK BLOOD SMEAR

Ring form Early trophozoites

Thin Blood Film Thick Blood Film

TROFOZOIT MUDA : PARASITSitoplasma dan kromatin halus1@ 2 double chromatinTerdapat juga marginal (accolle form) bentuk tepian1 atau lebih parasit dalam 1SDM (multiple infection)Tidak terdapat pigmen

TROFOZOIT MUDA : PERUMAHSaiz tidak berubah Tiada stippling

Trofozoit MatangPARASITBentuk cincin yang lebih besar dan irregularSaiz lebih kecil daripada spesies lainKromatin lebih besarSitoplasma padatKadang – kadang terdapat pigmen kasar berwarna perang kehitaman

PERUMAHTerdapat Maurer’s spotSDM mungkin kecut dan crenated

Plasmodium falciparum - Ring

Skizon Muda dan MatangMUDABentuk padat dan hampir memenuhi SDMPigmen berselerakanKromatin irregular

MATANGHampir memenuhi SDMMerozoit semakin kecilPigmen berwarna kuning coklat (tengah)

Dilapor berada dalam infeksi yang serius / dikulturJika ada , pesakit mungkin sudah meninggalBoleh dijumpai dalam saluran darah di dalam organ

Mature SchizontDeveloping Schizont

Mature schizont in a thin blood smear.

Ruptured schizont in a thin blood smear.

Another schizont in a thin blood smear.

GAMETOSIT BETINABETINABentuk cresent/ bulan sabit dengan hujung yang lebih tajamSaiz lebih besar daripada SDMWarna sitoplasma : biru gelapKromatin : padat berkumpul di tengahPigmen : rice grain mengelilingi kromatin

GAMETOSIT JANTANJANTANBentuk cresent/sabit/pisang dengan hujung lebih tumpulSaiz lebih besar daripada SDMWarna sitoplasma : Biru pucatNukleus : besar dan tidak padat, dark pinkKromatin : berselerakanPigmen : granul warna keemasan yang berselerakan (rice grain)

Two gametocytes in a thin smear. Gametocyte in a thin smear showing the membrane of the rbc.

Gametocytes in a thick smear Gametocytes in a thick smear

Plasmodium falciparum

Rings: double chromatin dotsmultiple infections in same red cell

Gametocytes: mature (2)andimmature (1) forms (1is rarelyseen in peripheral blood)

Trophozoites: compact*(rarely seen in

peripheral blood)

Schizonts: 8-24 merozoites*(rarely seen in peripheral blood)

Infected erythrocytes: ***normal size (Maurer’s dots)

2 1

1

2 3

4

Species Differentiation on Thin FilmsFeature P. falciparum P. vivax P. ovale P. malariae

Enlarged infected RBC + +

Infected RBC shape round round, distorted

oval, fimbriated

round

Stippling infected RBC Mauer clefts Schuffner spots

Schuffner spots

none

Trophozoite shape small ring, appliqu

large ring, amoeboid

large ring, compact

small ring, compact

Chromatin dot often double single large single

Mature schizont rare, 12-30 merozoites

12-24 merozoites

4-12 merozoites

6-12 merzoites

Gametocyte crescent shape large, round

large, round

compact, round