CAMLPR Hematology Practice Test

Schuffner's stippling are fine, eosinophilic dots in the cytoplasm of red blood cells that are infected by certain malaria parasites. This pattern is most strongly associated with Plasmodium vivax (and can also be seen with Plasmodium ovale), reflecting changes in reticulocytes that the parasite causes as it develops. On a blood smear, P. vivax usually also enlarges the infected red blood cells and presents with trophozoites and multiple abnormalities in the cytoplasm, all of which together point toward this species. In contrast, Plasmodium falciparum tends to show multiple small ring forms and characteristic banana-shaped gametocytes and typically lacks Schuffner stippling; Babesia can mimic some malaria features but shows Maltese cross tetrads in red blood cells rather than Schuffner dots. Therefore, the presence of Schuffner's stippling most strongly indicates Plasmodium vivax.