K0123456 Burnham MICHAEL 01.02.03 M Accident & Emer
Specimen R,18.0006197.A Clin dets fall, tender left hip and l3-l5 fracture
Collected 15.01.18 NK A.Diag
-------------- high intensity test code => unauthorised result -------------
PT 11.5 |RDW + 29.5 |
APTT 29.0 |Neuts NA |NRBC's 2.5
FIB + 6.99 |Lymphs NA |NUCA 0.27
Hb - 82 |Monos NA |
WBC + 10.66 |Eosin NA |
Plts 327 |Baso NA |
Hct - 0.288 |FILM Film Made |
RBC - 2.79 |MNEUT + 9.63a |
MCV + 103.2 |MLYMP - 0.69a |
MCH 29.4 |MMONO 0.34a |
MCHC - 285 | |
An interesting finding on an admission to the A&E department
Turns out the patient has had a splenectomy in the past. To quote an on-line source:
“In our consult experience misinterpretation of the blood smear findings in the splenectomized patient is a cause of significant misdiagnosis.The blood changes following splenectomy are relatively predictable and knowing these changes can obviate a wrong diagnosis and therapy in your patient.”
Labels: case study
Whilst getting the information together for the last few write-ups I learned a new phrase: “accole malarial forms”.
There’s more about the things here.
I’ve always known that trophozoites of P falciparum can be found on the edge of the red blood cells. I didn’t know that these are known as accole forms.
There’s three distinct types:
The single chromatin bead lies on the edge of the cell with most of the cytoplasm
extended along the edge on both sides of the bead.
The complete parasite lies in a thichened line along the edge of the cell with no evidence of ring formation.
The parasites are displaced beyond the edge of the host cell. All degrees of displacement may occur, from partial to marked displacement with most of the parasite lying beyond the cell margin.
One lives and learns…
While I’m at it – the December 2017 digital morphology exercise
At first sight not too good… but then again, what’s in a name?
I’m pleased with that !!