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Malaria (Pl. Falciparum)


This patient was hospitalized in a critically ill condition on return from a visit to Ghana with a fever of 40ºC, violent headaches, myalgia and severe diarrhea. His admission blood sample showed mild lymphocytosis in combination with thrombocytopenia. The lymphocytosis was accompanied with an ATYP DEP (atypical depolarization) and VAR LYM flag alert. In the blood smear about 23% of his erythrocytes were infected by malaria parasites. A diagnosis of Plasmodium falciparum malaria was made.


In the GRANULARITY/LOBULARITY plot, numerous purple-colored cells with atypical depolarization were visible, above the normal monocyte position. Events coded by MAPSS as monocytes (purple) normally never depolarize light. This pattern is compatible with monocytes that have ingested malaria-derived hemozoin pigment.


Patient was treated with an experimental anti-malaria drug and released after 6 days from the hospital without complications.

Numerical Results

WBC 11.3 10e3/μL
NEU 2.253 19.888 %
BLST .030 .262 %
MONe 1.21 10.7 %
EOS .214 1.88 %   ATY DEP
BASO .065 .577 %
LYM 7.574 66.7 %   VAR LYM

RBC 4.32 10e6/μL
HGB 14.2 g/dL
HCT 39.1 %
MCV 90.5 fL
MCH 32.8  pg
MCHC 36.3 g/dL
RDW 13.2 %

PLT 73.4 10e3/μL
MPV 5.42 fL

CELL-DYN Ruby Casebook. Malaria (Pl. Falciparum. 2018. ADD-00005070. p.49
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