Lymphocytes highly vacuolated cytop

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Lymphocytes highly vacuolated cytop

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8 Posts

Oussama77
Forum Junior

Topics: 9
Posts: 58

08/28/08 - 01:51 PM

25yr old female with 5 day h/o sore throat,fatigue,headache,smoker. on exam post cervical l.node mild splenomegaly present with pharyngitis.

WBC 16,000 55%L
HB 13.5
PLAT 216,000 various forms of lymphocytes r here,cells with convoluted nuclei and highly vacuolated cytoplasm seen. rapid strept test,urine,heterophill ab -ve.DX?

1) Hodgkins lymphoma
2) NHL
3) IM
4) Myelodysplasia
5) infectious reaction.

I found this Q and did not understand it. !?

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Eagle_303
Forum Guru

Topics: 77
Posts: 655

08/28/08 - 02:52 PM

It is infectious mononucleosis

nightflight1945
banned

Topics: 32
Posts: 920

08/28/08 - 10:35 PM

5) infectious reaction.

mistake in typing

IM is the correct answer

Edited by nightflight1945 on 08/28/08 - 11:35 PM

Eagle_303
Forum Guru

Topics: 77
Posts: 655

08/28/08 - 11:14 PM

nightflight1945 wrote:
5) infectious reaction.

That is great dear nightflight.

Would you please guide which viral infection (for that matter any infection) other than EBV can give rise to

sore throat
Fatigue
Cervical lymphadenopathy
splenomegaly
Lymphocytosis
Atypical lymphocytes

???

nightflight1945
banned

Topics: 32
Posts: 920

08/28/08 - 11:35 PM

it was an error in copy/paste !

infectious mononucleosis is the answer.IM

ngaybinhyen
Forum Guru

Topics: 23
Posts: 657

08/29/08 - 11:12 PM

In this case, even though FA -ive, CBC +
In case, both FA and CBC -ive ==> VCA IgM
If VCA IgM -ive ==> IM-like organism (CMV)

And by the way, skin rask appears after Ampicillin use (both EBV & CMV)

Rx = Tylenol/NSAIDs
Steroids only in lifethreatening condition (airway obstruction, autoimmune hemolytic anemia, severe thrombocytopenia, and aplastic anemia, CNS involvement)

(as it may rarely complicate encephalitis and myocarditis and theoretical risk to inhibit immune response, reserve larger reservoir of latently infected cells, potentially put patients at risk for EBV-associated malignancy)

No ATB. No Acyclovir (not effective in vivo)

Edited by ngaybinhyen on 08/30/08 - 01:05 AM

hero
Forum Guru

Topics: 42
Posts: 549

08/29/08 - 11:47 PM

ngaybinhyen wrote:
...
And by the way, skin rask appears after Ampicillin use

- how you treat that one?

ngaybinhyen
Forum Guru

Topics: 23
Posts: 657

08/30/08 - 01:22 AM

The rash is pretty impressive. I don't know how to treat this skin manifestation.

Please post the source

The rash is copper-colored and appears mainly over the trunk. It can develop into an extensive, confluent, maculopapular pruritic eruption that includes the palms and soles. It can persist for up to 1 week, with desquamation occurring over a span of several more days. The rash can also occur with ampicillin derivatives such as amoxicillin[44] and other penicillins such as methicillin.[45] Rash does not represent hypersensitivity to ampicillin, which can be used safely when the infection subsides. [46] [47] [48] [49] Similar rashes have been reported in individuals with EBV infection following the use of cefprozil[50] and azithromycin

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