2012-01-31

Mystery cells, case #7

Here is another case from Copenhagen University Hospital in Denmark. Margit Grome, Biomedical Laboratory Scientist, and her colleague Lennarth Friis-Hansen M.D., give you the details:

A woman, age 32 was hospitalized at the department of Infectious Diseases.
A CSF was collected and sent to the lab.
The results were:

  • Erythrocytes: 2280 x 106/l
  • Leukocytes:    339 x 106/l
  • Glucose:  0,8 mmol/l    (ref; 2,2 – 3,9)
  • Protein:  1,68 g/l         (ref: 0,15 – 0,50)

A Cytospin-smear was prepared and MGG-stained. Differential count was performed using the CellaVision Body Fluid Application and the CellaVision DM96.

The cells looked like this:

The analysis showed:

  • 50 %  Neutrophils
  • 16 %  Lymphocytes
  • 0,5 % Eosinophil
  • 22 %  Monocytes/macrophages

What do you think about the womans condition?
And – what the cells in row 4?

16 thoughts on “Mystery cells, case #7”

  1. Cryptococcus. Also present in the 4th row second image engulfed in the cytoplasmic vacuole of the cell a single bacteria (cocci) and also in the 1st row first image possible diplococci.

  2. is this an HIV patient?if so,she is an immunocompromised patient with HIV infection and already acquiring immunosuppressed dse. form of opportunistic fungi which is a Cryptococcus Neoformans as i could see the encapsulated cell (fungi) in row #4

    1. Firstly we count all the cells, which we suspect are nucleated. Then we perform a differential count (if Nucleated cells are > 10 x 10^6). If the diff shows, that there are other cells than WBC, we try to correct the count if possible. If not – we add a comment to the WBC- koncentration-result.

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