Fortuitous discovery of a microfilaria of the genus Loa loa during a routine blood smear at the Hematology Laboratory of the Mohamed V Military Instruction Hospital in Rabat: A case report

  1. Mohammed Labrigui
  2. Hamza Layat
  3. Manal Bouikhif
  4. Fatima Ziad
  5. Zimi Khalil
  6. Zineb Jerroundi
  7. Hafid Zahid
  8. Zohra Ouzzif

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Abstract

Loiasis is a parasitic infection transmitted by a vector, specifically through the bites of Chrysops genus tabanid flies. It is often associated with marked and persistent eosinophilia in affected individuals. We report the case of a 28-year-old Cameroonian male. His medical history includes an episode of malaria treated on an outpatient basis. As part of a diving internship in Morocco, the young serviceman underwent a medical fitness examination at the CEMPN (Medical Expertise Center for Aircrew Personnel) of the Mohamed V Military Hospital, which included a biological assessment. This revealed a mildly elevated bilirubin level, lactate dehydrogenase (LDH) activity at the upper limit of normal, and eosinophilia at 1500/µl, without anemia or thrombocytopenia. A blood smear was prepared and stained with May-Grünwald Giemsa (MGG), revealing the presence of several small worms, with an appearance consistent with Loa loa microfilariae. This case of Loa loa, identified in the hematology laboratory, is one of the rare diagnoses in Morocco. Therefore, microbiologists need to remain vigilant and carry out a thorough analysis of the blood count and blood smear.

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  1. Version published to 10.1099/acmi.0.000895.v2 on Access Microbiology
  3. Access Microbiology

    Comments to Author

    Please ONLY put comments for the Author(s) in here 1. Page 1, line 16 and 17 16 We present a case involving a 28-year-old Cameroonian soldier who underwent a blood 17 examination. It is not clear why the patient presented to healthcare facility and the reason for taking blood samples. Review the statement and consider re-writing: We present a case involving a 28-year-old Cameroonian soldier who underwent a blood examination as part of routine medical examination. (Or any other reason for consultation) 2. Review the statement, "non-inflammatory". Do you mean the skin nodule not being cellulitic? The description non-inflammatory describes a cellular and histopathological findings rather than clinical and physical examination findings. 41 V Military Hospital (HMIMV). The clinical examination revealed no abnormalities except for 42 two small, non-painful, non-inflammatory skin nodules on both ankles (Figure 1). 3. Finally, there's need to review the word "biologist" in line 94 These data should alert biologists, particularly in non-endemic countries like Morocco. Could it better be described as microbiologist, laboratory scientists or biomedical scientists?

    Please rate the quality of the presentation and structure of the manuscript

    Good

    To what extent are the conclusions supported by the data?

    Strongly support

    Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?

    No

    Is there a potential financial or other conflict of interest between yourself and the author(s)?

    No

    If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?

    Yes

  4. Access Microbiology

    Comments to Author

    Specific comments: Abstract: 1. Abstract should be according to journal guidelines (whether structured or not) 2. Highlight this is a rare study Case presentation: 1. Proper history of patient has not been taken like what was the reason given by patient regarding these two small, non-painful, non-inflammatory skin nodules on both ankles. 2. At what time sample has been taken. It is important because the diagnosis of worm Loa loa. 3. In the study, authors used the terminology 'worm', it should be 'larvae or microfilaria'. 4. How the authors have confirmed the diagnosis is not clear (line 59) 5. No serological and molecular investigation has been done. 6. Treatment and follow-up portion is not complete. (line 64-65) Discussion: It is written well. I suggest that the authors carefully edit and proofread the entire manuscript thoroughly, before submitting it again to this journal. Please ONLY put comments for the Author(s) in here

    Please rate the quality of the presentation and structure of the manuscript

    Satisfactory

    To what extent are the conclusions supported by the data?

    Partially support

    Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?

    No

    Is there a potential financial or other conflict of interest between yourself and the author(s)?

    No

    If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?

    Yes

  5. Access Microbiology

    Comments to Author

    Reference number 7 didn't appear completely in the reference list.

    Please rate the quality of the presentation and structure of the manuscript

    Good

    To what extent are the conclusions supported by the data?

    Strongly support

    Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?

    No

    Is there a potential financial or other conflict of interest between yourself and the author(s)?

    No

    If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?

    Yes

  6. Version published to 10.1099/acmi.0.000895.v1 on Access Microbiology