Hello again,
Great to know that you are feeling better.
Did you have just a single blood smear? Thick or thin?
The repeat CBC makes very good sense.
In the absence of symptoms and signs, the malaria IGG will have poor sensitivity and specificity.
~•~ Dr. Parks
This answer is not intended as and does not substitute for medical or legal advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
Hello,
Yes, interesting indeed. The monocystosis can be consistent with malaria in the context of your history.
I would encourage you to remember the caveats and recommendations concerning blood smears.
From emedicine.com @http://emedicine.medscape.com/article/221134-diagnosis
Thick smears:
Three thick and thin smears 12-24 hours apart should be obtained. The highest yield of peripheral parasites occurs during or soon after a fever spike; however, smears should not be delayed while awaiting fever spikes.
Thick smears are 20 times more sensitive than thin smears, but speciation may be more difficult. The parasitemia can be calculated based on the number of infected RBCs. This is a quantitative test.
Thin smears:
Thin smears are less sensitive than thick smears but facilitate speciation. This should be considered a qualitative test.
Treatment greatly depends on the identification of the Plasmodium species responsible for the infection.
Feel free to keep this line of communication open.
~•~ Dr. Parks
This answer is not intended as and does not substitute for medical or legal advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
Did a repeat CBC and the monocytosis totally cleared. And I've been feeling fine.
The blood smear was ordered to look for malaria and I think they did thin and thick smears.
In any case will just chalk up the illness to some weird flu virus and hope it doesn't recur.
Again, appreciate your feedback.
Jerry
The smear came back negative and I have been afebrile with good energy for past 36 hours. Illness lasted 6 days.
Think I will just wait things out for now. Consider repeat of CBC in a few weeks? Maybe malaria IGG would be helpful? My doc will be back in town in another 10 days and I'll run it by him.
Do you know much about usefulness of the plasmodium IGG testing, I have read differing reports of its specificity and sensitivity.
Thanks.
Dr. Parks,
Really appreciate the quick and helpful response. I did get to chat with one of the infectious disease docs in town and he pretty much had the same thoughts as you.
Smears pretty specific but not real sensitive, especially since mine was not done during a fever spike. Will let you know the smear result when I get it.
Plasmodium vivax is the only malaria bug in Belize according to the CDC. Not sure whether empiric treatment, assuming neg smear, would be justifiable.
Thanks again.
Jerry