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Pathological Case of the Month

Pathological Case of the Month Abstract DURING WINTER, two previously healthy 7-week-old infants presented with cough, rhinorrhea, and fever. Results of their physical examinations were remarkable only for tachypnea, congested nares, end-expiratory wheezes, and intercostal retractions. A chest radiograph from one infant is depicted in Figure 1. Complete blood cell and differential white blood cell counts were performed on each child and revealed total white blood cell counts of 26×109/L and 15.6×109/L. A predominance (0.75) of lymphocytes with many atypical forms was noted on their peripheral blood smears (Figure 2). Due to the concern of whether the atypical lymphocytes might represent leukemic blasts, an oncologist was consulted. Both infants made uneventful recoveries from their respiratory tract infections and had gradual diminution of both total leukocyte counts and atypical lymphocyte forms. Diagnosis and Discussion Peripheral Blood 'Virocytes' Associated With Respiratory Syncytial Virus BronchiolitisThese infants presented with the typical signs and symptoms of viral bronchiolitis: fever, References 1. Hall CB. Respiratory syncytial virus . In: Feigin RD, Cherry JD, eds. Textbook Pediatric Infectious Diseases . 3rd ed. Philadelphia, Pa: WB Saunders Co; 1992: 1633-1656. 2. Miale JB. Morphology of blood and bone marrow cells . In: Miale JB, ed. Laboratory Medicine Hematology . 5th ed. St Louis, Mo: Mosby–Year Book; 1977: 134-272. 3. Sullivan JL, Woda BA. Lymphohistiocytic disorders . In: Nathan DG, Oski FA, eds. Hematology of Infancy and Childhood . 4th ed. Philadelphia, Pa: WB Saunders Co; 1993:1354-1374. 4. Mahoney DH Jr, Fernbach DJ. The hematologic response . In: Schlossberg D, ed. Infectious Mononucleosis . 2nd ed. New York, NY: Springer-Verlag NY Inc; 1989:80-88. 5. Okabe N, Hashimoto G, Abo T, Wright PF, Karzon DT. Characterization of the human peripheral blood effector cells mediating antibody-dependent cell-mediated cytotoxicity against respiratory syncytial virus . Clin Immunol Immunopathol . 1983;27:200-209.Crossref 6. Domurat FM, Keng P, Mock DJ, Roberts NJ Jr. Early identification and retrieval or deletion of human lymphocyte subpopulations responding to influenza virus or respiratory syncytial virus challenge . Cell Biophys . 1989;15:173-187.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170220099016
Publisher site
See Article on Publisher Site

Abstract

Abstract DURING WINTER, two previously healthy 7-week-old infants presented with cough, rhinorrhea, and fever. Results of their physical examinations were remarkable only for tachypnea, congested nares, end-expiratory wheezes, and intercostal retractions. A chest radiograph from one infant is depicted in Figure 1. Complete blood cell and differential white blood cell counts were performed on each child and revealed total white blood cell counts of 26×109/L and 15.6×109/L. A predominance (0.75) of lymphocytes with many atypical forms was noted on their peripheral blood smears (Figure 2). Due to the concern of whether the atypical lymphocytes might represent leukemic blasts, an oncologist was consulted. Both infants made uneventful recoveries from their respiratory tract infections and had gradual diminution of both total leukocyte counts and atypical lymphocyte forms. Diagnosis and Discussion Peripheral Blood 'Virocytes' Associated With Respiratory Syncytial Virus BronchiolitisThese infants presented with the typical signs and symptoms of viral bronchiolitis: fever, References 1. Hall CB. Respiratory syncytial virus . In: Feigin RD, Cherry JD, eds. Textbook Pediatric Infectious Diseases . 3rd ed. Philadelphia, Pa: WB Saunders Co; 1992: 1633-1656. 2. Miale JB. Morphology of blood and bone marrow cells . In: Miale JB, ed. Laboratory Medicine Hematology . 5th ed. St Louis, Mo: Mosby–Year Book; 1977: 134-272. 3. Sullivan JL, Woda BA. Lymphohistiocytic disorders . In: Nathan DG, Oski FA, eds. Hematology of Infancy and Childhood . 4th ed. Philadelphia, Pa: WB Saunders Co; 1993:1354-1374. 4. Mahoney DH Jr, Fernbach DJ. The hematologic response . In: Schlossberg D, ed. Infectious Mononucleosis . 2nd ed. New York, NY: Springer-Verlag NY Inc; 1989:80-88. 5. Okabe N, Hashimoto G, Abo T, Wright PF, Karzon DT. Characterization of the human peripheral blood effector cells mediating antibody-dependent cell-mediated cytotoxicity against respiratory syncytial virus . Clin Immunol Immunopathol . 1983;27:200-209.Crossref 6. Domurat FM, Keng P, Mock DJ, Roberts NJ Jr. Early identification and retrieval or deletion of human lymphocyte subpopulations responding to influenza virus or respiratory syncytial virus challenge . Cell Biophys . 1989;15:173-187.Crossref

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Sep 1, 1995

References