2 February 2018 (Friday) - Glandular Fever

 Here’s something that came up at work today:
 

PIKE, Captain Christopher   d.o.b.  1-2-2001 R,18.0013845.S       U 02.02.18  Clinical details  ?quincey             HBM   WBCM    PLT    HCT   RBCM   MCVM   MCHM  MCHCM    RDW      N 020218 F    126  19.74    332  0.385   4.44   86.7   28.4    327   13.5   5.35               L      M      E      B    NUC   NUCA    ESR     GF 020218 F  11.15   2.44   0.44   0.36

Look at that lymphocytosis. Generally that is never a good thing. But looking down the microscope combined with the patient’s age I did a glandular fever test (just as the A&E department phoned to ask me to do so)

It was positive… I suspected that. But look at the original count… Is that basophilia true? I did a manual diff

WBCM MNEUT MLYMP MMONO  MEOS MBASO  META MYELO  PROM BLAST  NRBC         (3)   (2)   (1)   (4)   (5)   (6)   (7)   (8)   (9)  #(0)  150    52    89     8     1     0     0     0     0     0     0   19.7   6.9  11.7   1.1   0.1   0.0   0.0   0.0   0.0   0.0   0.0​

I didn’t see a single basophil. This is often the case in glandular fever; the analysers seem to pick up a false basophilia. Always do a manual diff in such a case…