This came up
on a Facebook group I follow today.
“An 11 month old boy presented to ED with
tiredness, temperature of 38.8°C, rashes to both thighs and arms, inactiveness.
Routine Haematology, Biochemistry including VBG and CRP, and blood cultures
were done.
WBC 13.6, Neuts 7.0 Lymph 4.9 Mono 1.5
Hb 122g/L, MCV 76.6 RDW 16.2 Plt 299 -
essentially normal, with slightly raised neutrophils. All Biochemistry results
were unremarkable, CRP 4mg/L (Normal <5). Blood cultures - negative.Now,
check out the blood films See if you can
identify the abnormal cells and an explanation for them.”
Well, these
are nucleated red cells…. Aren’t they…. ?
No
They are not….
What are
they? They are most odd. It turned out that due to some most unusual
combination of circumstances the patient’s blood sample got contaminated with
QC material. It is not unusual for fixed avian or reptilian blood to be used as
QC material.
It never occurred
to me that this might happen. Admittedly this is probably a once-in-a-lifetime occurrence,
but it is one to bear in mind nonetheless.
I had thought
about telling my colleagues about this… I probably shall, but part of me wants
to keep quiet in the hope that this amazingly unlikely event might take place
and then I can look clever.
In the
meantime I’m going to make a blood film on the QC material…
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