White Blood Cell Disorders and Platelets:: 6. Non Granulocytic White Blood Cells

Case history

  • A 14 year-old boy came to the physician's office with a sore throat that progressively worsened over a three day period. His posterior pharynx was swollen ,shiney and erythematous. The boy complained of pain on swallowing. His temperature was 98.5F.
  • A rapid direct streptococcal antigen test was positive.
  • However, his symptoms did not subside over the next two days while on antibiotic therapy. Anorexia and nausea were persistent and compounded by a frontal headache. Cervical lymph nodes became noticeably enlarged.
  • The results of the CBC were: WBC 11.9/mm3 with 17% segmented neutrophils, 5% bands, 72%(60% atypical--see photograph)lymphocytes and 6%monocytes. All red cell findings were normal.
  • A monospot test was positive.
  • This is a case of group-A streptococcal infection superimposed on infectious mononucleosis.
  • Symptoms subsided in 3 weeks following completion of the antibiotic therapy.

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