A soldier presents to a Veteran’s Hospital dermatology clinic complaining of a festering month long wound on his face that has not responded to antibiotics prescribed to him by his personal physician. He describes another similar wound on his right upper chest that has appeared in the last few days.. His physical examination is otherwise unremarkable. There are no systemic symptoms (he is afebrile, does not report any episodes of chills, has a normal pulse and blood pressure, and a normal CBC).
A close inspection of the lesions on the face and right upper chest can be described as open lesions that have a raised border with a central crater. There was a seropurulent discharge noted on the facial lesion. The central crater of the lesion on the face is slightly painful to the touch while the one on the chest is painless. Scabs can be noted on the central crater of the facial lesion. A slide impression is made of the facial and chest lesions, specifically from the edge, after making sure to expose the tissue by gently scraping the surface with a sterile scalpel. The glass slide used to make the impression was allowed to air dry and then sent to the laboratory to be stained with Giemsa stain.
The following is the Giemsa stain of the slide tissue impression.
Can you answer the following?
- What is identifiable in this Giemsa stained slide impression?
- From the clinical presentation, the history of the patient, and the above Giemsa stain result, what is the name of the parasite that this soldier is infected with?
- What is a predominant reservoir and vector of this parasite especially in the geographic area of this soldier’s deployment?
- What complications can occur from these infections?
- What is the treatment for this parasitic infection?