Abstract. The quantitative buffy coat (QBC) parasite detection method is a sensitive and specific tool for the diagnosis of malaria parasites. It is also useful for the diagnoses of other hemoparasites, including Trypanosoma, Babesia, and Leptospira. We report a case of relapsing fever diagnosed by this technique in a short-term traveler from Senegal. The diagnosis was confirmed by the standard Giemsa hemoscopy and by the identification of significant titers of antibodies to Borrelia spp. of tick-borne relapsing fevers by specific immunofluorescence and Western blot tests. The QBC technique seems to be useful in the diagnosis of tick-borne relapsing fever in blood samples and should be included in the management of fever in the traveler returning from tropical regions. The quantitative buffy coat (QBC) parasite detection method is based on the centrifugal layering of parasites into a 60-l blood capillary tube containing acridine orange dye. The test system was initially designed to simplify the diagnosis of malaria. For this disease, it has proved to be as sensitive and specific as the classic thick blood film hemoscopy. 1,2 The advantage of the QBC technique is in the shorter time required to observe specimens. 1 It is useful for the diagnoses of other hemoparasites, including Trypanosoma, Babesia, and Leptospira. 3,4 To our knowledge, this is the first case of relapsing fever diagnosed by the QBC fluorescence method.A 51-year-old Senegalese man developed intermittent fever and body weakness four days after returning from a three-month stay in Dakar, Senegal. He was later admitted to the University Teaching Hospital in Brescia, Italy for a fever of 10 days duration. The results of a physical examination was unremarkable, and the only symptoms he complained of were headache and asthenia. Among the baseline examinations, a blood film was prepared and 60 l of peripheral blood was taken for detection of hemoparasites. Giemsa-stained thick and thin blood films were negative for malaria parasites. A large number (approximately 10 per field at 1,000ϫ) of actively motile spirochetes were visualized by fluorescence microscopy on a fresh peripheral blood sample processed by the QBC technique. The organisms ( Figure 1A) appeared as fluorescent, greenish-yellow, filamentous bodies with 8-10 regularly spaced spirals that clearly stained against the dark background. The parasites were concentrated just above the platelet stratum of the buffy coat,
Abstract. Neurocysticercosis is rarely reported in short-term travelers, although the disease remains a major public health problem in tropical regions. We present a case of neurocysticercosis that was probably acquired by ingestion of Taenia solium eggs contained in the stomach of a pig butchered by the traveler. Complete clinical resolution was obtained by medical treatment, underlying the importance of early suspicion and diagnosis of the disease.
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