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What do you think these are, in my blood?

About microscopic forms of life, including Bacteria, Archea, protozoans, algae and fungi. Topics relating to viruses, viroids and prions also belong here.

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What do you think these are, in my blood?

Postby snowathlete » Fri Dec 06, 2013 10:23 pm

I'll start by saying that my doctor has already told me what he thinks it is, but still, I am interested to know what others think.

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Postby Cat » Sun Dec 08, 2013 6:25 pm

What are the stains?
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Re:

Postby snowathlete » Sun Dec 08, 2013 10:08 pm

Cat wrote:What are the stains?


Sorry I don't know. A vet I know offered to do it for me as a favour. I did the smears at home myself and sent them unstained. He then has obviously stained them but I don't know what he's used.
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Re: What do you think these are, in my blood?

Postby daniel.kurz » Mon Dec 09, 2013 4:29 am

Not knowing anything about you or your history, I would say that you don't have anything there except for platelets that are underlying/overlying your RBCs. I would like to know what the stains are and what led you to do a smear which would make this a lot easier. If it was an intracellular parasite, it would be staining well with Giemsa and we would be able to see some abnormal morphology.
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Postby biohazard » Mon Dec 09, 2013 11:34 am

With a quick look I doubt that they are platelets (usually if they are present, they are attached to other blood cells as 'satellites'). Not certain though, some more details about the stain would be nice indeed. Also, do you happen to have any images with white blood cells, this might give us some clues about the stain and general staining conditions. One option might be precipitates in the staining solution, which would make it just a staining artifact. I'll take another look at this with better time!
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Re:

Postby biohazard » Mon Dec 09, 2013 1:53 pm

biohazard wrote: (usually if they are present, they are attached to other blood cells as 'satellites')


This was perhaps an over-generalization; platelets do appear also as non-satellites. However, in my experience platelets often look more 'fuzzy' or blurry, so these still don't quite look like those. Also, they seem too basophilic if a Wright-Giemsa staining or similar was used. The size is about correct, though.
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Postby snowathlete » Mon Dec 09, 2013 2:31 pm

I will try and find out what stains were used and let you all know.

I was originally diagnosed with ME but saw a specialist who runs lots of exclusionary testing to rule out other diseases. I was postive for Bartonella, which is an intracellular bacteria. I therefore suspect that is what I am seeing in my blood.
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Postby biohazard » Tue Dec 10, 2013 7:38 am

I dare to say those are not bacteria. It is very uncommon to see bacteria in a correctly prepared blood film. If you had such a bacteremia that you can see them in your blood film, you would most likely be in a hospital now. And I assume you are not in a hospital :)
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Re:

Postby snowathlete » Tue Dec 10, 2013 1:08 pm

biohazard wrote:I dare to say those are not bacteria. It is very uncommon to see bacteria in a correctly prepared blood film. If you had such a bacteremia that you can see them in your blood film, you would most likely be in a hospital now. And I assume you are not in a hospital :)


I am not in hospital no, though I am very sick (house- and bed-bound).
Bartonella infect RBCs and are not often found extracellularly. If they were coming out as the blood cells die, could that allow their presence without being bacteremia?
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Re: Re:

Postby biohazard » Tue Dec 10, 2013 2:02 pm

snowathlete wrote:If they were coming out as the blood cells die, could that allow their presence without being bacteremia?


I suppose that could allow their presence in the blood film, although technically that is bacteremia then.

Nevertheless, those dots in the smear still don't quite seem like bacteria in my opinion, but I cannot say for certain from the images you posted. After all, a common Staphylococcus looks pretty much like a dark violet dot under most staining conditions. Though now as you said, there is an erythrocyte in the last panel (upper right-hand corner) that seems to have some staining that could be intracellular. Similarly, a couple of other erythrocytes have taken in some color but I am not sure if that is specific staining or an artifact. Otherwise the blue 'dots' in the images look mostly extracellular, though I am not certain what is the significance of this observation.

I have looked at a fair number of blood films and bacterial samples in my life, but unfortunately I do not recall ever seeing a case of bartonellosis among those, so I do not know for certain how it should look. Without special stains most bacteria simply look like various kinds of dots or rods that are difficult to tell apart from some other causes, such as inclusion bodies or precipitates in the staining solution.

The good side, though, is that Bartonella species are normally susceptible to many common antibiotics, so if you feel very ill and unsure of what is wrong, maybe you should just go to your nearest GP and sort it out?
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Re: What do you think these are, in my blood?

Postby daniel.kurz » Tue Dec 10, 2013 3:22 pm

If that is in fact Bartonella, that is an interesting presentation. The cell numbers are not what I would expect and stain surprisingly purple/blue.
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Postby snowathlete » Thu Dec 12, 2013 1:14 pm

I told my vet friend that my doctor thinks these are Bartonellae. It was my vet friend who took the photos. He disagrees with my doctor. He sees Bartonella in animals, and says they are different in shape, size and color. I know there are different species of Bartonella and some can look quite different to others, but I value my vet friend's opinion. He thinks these are a micrococci - perhaps Staphylococcus.

What do you think of that?

EDIT: Oh, btw, he said the staining is with the Wright modified stain.
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