Case #453 – October, 2017

A 38-year-old asplenic man residing in California was hospitalized with a 104º F fever, hematuria, myalgia, fatigue and thrombocytopenia. The patient had recently traveled to Arizona, Kansas and Oklahoma. A blood specimen collected in EDTA was sent to the hematology lab for routine work-up. Images were captured and sent to the DPDx Team for diagnostic assistance. Figures A – C shows what was observed by the technician in a thin smear for differential WBC count. What is your diagnosis? Based on what morphologic features?

This case and images were kindly provided by the California Public Health Laboratory, Richmond, California.

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Figure A

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Figure B

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Figure C

Images presented in the dpdx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.

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