PROTOZOAN GENUS NAMES TO MATCH TO THE CASESTUDY:      

Giardia                                                                                     Toxoplasma                                                   Trichomonas

Trypanosoma                                                                    Plasmodium

Case 4:

An 11-year-old boy in Thailand was admitted to the hospital dueto a sustained fever for 10 days prior to admission. He presentedwith fever and chills. There were no symptoms of cough or otherrespiratory tract involvement. There was no jaundice, but two daysbefore admission, there was a stomach-ache and vomiting, but nodiarrhea. He complained about myalgia (muscle aches) but did nothave any rash or hemorrhages.
His fever was 103^oF on admission, and his heart rate was140 bpm. He had mildly enlarged tonsils, a swollen leftsubmandibular lymph node and tachycardia. There was mild tendernessin the upper right quadrant of the abdomen, with mildly enlargedmargins of the liver. His spleen was normal. He had drowsiness butwas still oriented.
A peripheral blood smear showed normal-sized Red Blood Cells with afew ring-forms of a trophozoite inside the RBCs. On occasion, faintred dots were seen on the surface of the RBCs.
The patient was placed on Malarone and began to show signs ofrecovery within a few days.

Question 1: What is the name of this parasite?

Question 2: where is the trophozite of this parasite, usuallyreside?

_____________________________________________________________________________________________________________________________________________

Case 5

A pregnant woman who lived on a farm with many dogs and cats asoutdoor pets presented to an urgent care clinic during the15^th week of her pregnancy. She presented with fever,headache, enlargement of a lymph node on her neck, and symptoms ofa common cold.   She was placed on the antibioticCefixime, but she remained symptomatic despite theprescription.
An ultrasound of the fetus was taken at week 17, and it showed noanomalies. But since the patient was still symptomatic, she wasreferred to an ENT (Ear-Nose-Throat) specialist. Fluid wasextracted from a swollen lymph node which had continued to swell insize. No parasites were seen in a stain of the fluid. But afollow-up serological blood test was positive for antibodies to thesuspected parasite. Under the microscope, the trophozoite of thisparasite would be crescent-shaped, 6 micrometers in length, with aprominent nucleus, a pointed anterior end, and a rounded posteriorend.
The patient was given pyrimethamine and sulfadiazine, but she couldnot tolerate them, developing a petechial rash. Spiromycin was thenprescribed.
At the 24^th week of pregnancy, a fetal scan showedpronounced hydrocephaly and decreased amniotic fluid. The physicianrecommended termination of the pregnancy, and it was terminated at178 days. The male fetus was covered in meconium and had developedthe same petechia as the mother had during her drug reaction.

Question 1: what is the risk factor in this case?

Question 2:what is the caustive agent?