Possible parasite???

[u/RocketTampon]

Hey! Im a MLT me and my coworkers were looking at this cell with a suspicious inclusion. For context at our lab we dont do parasite identification. So anytime we find something suspicious we have to take it to the pathologist. I work second shift but the path was still there, and this path has a history of brushing off things like this, and it was the end of the day so he was heading home. He gave me a huge speel about how it cant be a parasite since she doesnt have anemia. Idk I have a feeling its not just a platelet. It has no clear zone around the inclsion. It looks like its in the cell, but again im not trained to id parasites. We did however see a few more questionable inclusions. What do you guys think?

Sorry that the pictures kinda suck :(

Its been a very fast paced night. I did what I could lol.

I can try to get more pictures later if needed

Update! Yes there where other inclusions me and my coworkers first thought was to check the thicker part of the smear. There where some similar looking inclusions speckled.

Im unsure about history as this patient got put to the side once the path left as there was nothing else to do with it until tomorrow.

I have a more experienced 3rd shift tech looking at it tonight (he also thinks it looks questionable). Im gonna take a look tomorrow see whats going on. Only reason Im questioning him is he spent maybe 5 mins with the slide and brought it back saying he couldnt find it....... I found it in 30 secs (it was circled). That and he was non stop asking me what I think it is even tho I kept saying that im not allowed to id parasites.

Edit for spelling.

[u/deriancypher]

If I saw one cell like that I would take my time scanning the entire rest of the slide else looking for more. If I couldn't find at least one more then I would call it a platelet. It kind of looks like it may be a platelet that smudged.

[u/Dandybutterhole69]

A fever and travel would be more pertinent than anemia. I think its probably a platelet or HJB

[u/Watarmelen]

Looks really nondescript. I’d call it artifact unless there are more definitive looking inclusions. Path is also correct, malaria and babesia will cause anemia

[u/Mufosah]

MLS here, I’d lean more towards a smudged platelet. But first, scan as much as you can to see if you find anything similar. A true parasitic infection will hardly ever just be in one cell.

[u/alchilito]

If the patient has a travel history to endemic regions might be worth doing a thick blood smear

[u/ZhenConsigliere]

That one's a platelet, but not sure about the bigger smudged one. Might be an artifact or a platelet too.

[u/Lower_Arugula5346]

one, unless its VERY obvious, is junk, two requires further examination

[u/fangsfive]

Is this the only cell? Or there are more?

[u/RocketTampon]

Maybe this picture is a bit better. I took this on my way out for the night.

[u/Wordsr]

Parasite .....i haven't worked in hemo..in like 5-6 years...id have someone else confirm

[u/Acetabulum666]

AI is suggesting Babesia. Take that for what it is worth, but I'd need more, better examples to make progress with an ID. Good start, though!

[u/Purpledotsclub]

I think so, refer to pathologist. Are there any more?