Plasmodium falciparum: Blood Stage Parasites

Fig. 1: Normal red cell; Figs. 2-18: Trophozoites (among these, Figs. 2-10 correspond to ring-stage trophozoites); Figs. 19-26: Schizonts (Fig. 26 is a ruptured schizont); Figs.27, 28: Mature macrogametocytes (female); Figs. 29, 30: Mature microgametocytes (male).
Illustrations from: Coatney !, Collins "#, "arren M, Contacos $ . The $rimate Malarias. %.S. &epartment of 'ealth, #ducation and "elfare, (ethesda, )*+).

!i"# Blood Smears

Illustrations from: "ilco, -. Manual for the Microscopical &iagnosis of Malaria in Man. %.S. &epartment of 'ealth, #ducation and "elfare, "ashington, )*./.

Smears from $atients: Plasmodium falciparum rings ha0e delicate cytoplasm and ) or 1 small chromatin dots. !ed 2lood cells (!(Cs) that are infected are not enlarged; multiple infection of !(Cs more common in P. falciparum than in other species. 3ccasional appli4u5 forms (rings appearing on the periphery of the !(C) can 2e present.

% B & %, B, &: Multiply infected red 2lood cells 6ith appli4u5 forms in thin 2lood smears.

' ': Signet ring form. (: &ou2le chromatin dot.

) ): - thic7 2lood smear sho6ing many ring forms of P. falciparum.

Plasmodium falciparum:

ro$!o*oites

Smears from $atients: -lthough rarely seen in peripheral 2lood smears, older, ring stage parasites are referred to as trophozoites. The cytoplasm of mature trophozoites tends to 2e thic7er and more dense than in younger rings. -s P. falciparum trophozoites gro6 and mature, they tend to retain their ring-li7e shape and sometimes trace amounts of yello6 pigment can 2e seen 6ithin the cytoplasm. ro6ing trophozoites in P. falciparum can appear slightly amoe2oid in shape.

%: -ppli4u5 trophozoite8 Note the slight amoe2oid appearance of the parasite. B: - larger, more mature trophozoite and smaller, younger ring stage parasites in a thin 2lood smear. C &

&, ': More mature and compact trophozoites. Note the presence of pigment in &.

Plasmodium falciparum: S"!i*onts

Smears from $atients: Schizonts are seldom seen in peripheral 2lood. Mature schizonts ha0e 9 to 1: small merozoites; dar7 pigment, clumped in one mass.

% %: ;mmature schizont in thin 2lood smears. B: Mature schizont.

C D &, ': !uptured schizonts in a thin 2lood smear.

Plasmodium falciparum8 )ameto"+tes

Smears from $atients: Plasmodium falciparum gametocytes, 6hen mature are crescent or sausage shape. The red 2lood cell is often distorted or not 0isi2le.

& ' %, B, &, ': ametocytes of P. falciparum in thin 2lood smears. Note the presence of a <=a0eran>s 2i2,? 6hich is not al6ays 0isi2le.

( (: T6o gametocytes captured from a thic7 2lood smear.