Microscopic Artefacts in Clinical Practice- A Diagnostic Dilemma

Abstract

Clinical Microbiologists often come across strange structures during microscopic examination of clinical specimens which are often confused with and misreported as micro-organisms. We studied series of cases in a super speciality hospital from January 2015 to December 2016 with the aim of enumerating artefacts and mimickers that may simulate infectious agents. Microscopic examination of various clinical specimens like pus, tissue, sputum and blood (for peripheral smear examination) received by the department of Microbiology during this period was carried out as per requisition received from clinicians. Photographs of several microscopic artefacts were obtained using a high definition camera. For comparative purpose, photographs of common pathogenic micro-organisms closely resembling these structures were also obtained. Various microscopic artefacts closely resembling pathogenic micro-organisms like fungal hyphae, microfilariae, malaria parasites, acid fast bacilli, budding yeast cells and hooklets of Echinococcus granulosus were observed during the course of this study and enumerated. Owing to paucity of available literature, it is absolutely essential to highlight the issue of misreporting of infectious diseases during microscopic examination of clinical specimens.

Keywords

• artefacts
• microbiology
• microscopic examination