Case 43 -- Intermittent fevers

*This is the Clinical Pathology Case of the Month for October, 1995.

Contributed by Christine Dorvault, MD andCharles A. Richert, MD
Published on line in October 1995

A peripheral blood smear from a local student health clinic was referred to the pathologist for review at 5:00 P.M. on a weekday.


When the peripheral smear was reviewed, attempts were made to contact the clinician who ordered the test. Unfortunately, the student health clinic was closed and no physician was serving as an on-call physician. The following morning the patient history was obtained from the clinician: The patient is a 43 year old black man from Gambia, Africa who recently presented to the student health service with the chief complaint of intermittent fevers. He had a white blood cell count of 7.2 x 10 (9)/L, hemoglobin of 14.5 g/dl, hematocrit of 42.2 %, and a mean corpuscular volume of 94 %. Manual differential showed 86% polymorphonuclear leukocytes, 11 % lymphocytes, and 3% monocytes.




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