This week’s case involves a 34 year old aid worker, who recently returned to the UK after spending two years in West Africa, with significant time spent in the rainforest regions.

The patient reported episodes of “creeping” sensations under the skin and localised, non-pitting oedema on the wrists and ankles that disappears after a few days.

The GP requested a Full Blood Count. The FBC showed:

• WBC: 12.4 x 10_⁹/L
• Hb: 132g/L
• PLT: 98 x 10_⁹/L
• Eosinophils: 4.2 x x 10_⁹/L

A wet prep was done to rule out platelet clumps and a peripheral blood film was made and stained to determine the cause of the increased eosinophils.

The sample was incidentally taken around midday. What significance does that have in this case? Can you identify what was seen on the film?

See you on Friday for the reveal!