Answer to Case 743

 Answer to theParasite Case of the Week 743: Brugia timorimicrofilariae. This was one of the tougher cases, but everyone did a great job narrowing the differential toBrugia. As noted by Florida Fan and Anonymous, we can immediately rule outMansonellaspecies based on the small size (length and diameter) of the microfilariae. Florida Fan also notes that the sheath is visible, confirming that we are dealing withLoa loa,Wuchereria bancroftior theBrugiagenus. He then details his method for coming to an exact diagnosis: " First the column of nuclei is so compact that we can rule outWuchereria bancrofti, also the nuclei go to the end of the tail. Yet, the two terminal nuclei are distinctly separated from the nuclei column, this rules out any chance of beingLoa loa. Now we have theBrugiagenus left, but where is the pink sheath pertinent toBrugia malayiwhen stained with Giemsa stain? As such, we eliminateBrugia malayi. By the elimination process, we ’re left with its cousinBrugia timori, the sheath of this one does not stain pink with Giemsa stain. Now let ’s check the map of the lesser Sundae island, the Alor island is right North of Timor. "I will also point out that the head space is longer than that ofB. malayiand there are a larger number of single-file nuclei going towards the tail. These features are more subtle and can be difficult to appreciate. I ' ve done my best to point out some of them in the image below.Thank you all for sticking with us on our microf...
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