Slide 007: Diagnosis: infectious mononucleosis Available data: 19 year- old male presented with three days of fever and chills, sore throat, tender glands, fatigue and body aches. Throat culture for group A streptococcus negative. Patient was prescribed Keflex for 7 days. One week later, the patient presented with persisting sore throat symptoms, temperature of 99oF, spleen not palpable. A CBC was performed, revealing many atypical lymphocytes. Direct bilirubin was 0.7mg/dL, ALT 560 U/L, AST 330 U/L, and LDH 719 U/L. Monospot was positive. Major cell findings included atypical lymphocytes and smudge cells. Toxic granulation and echinocytes, while not in abundance, were present on this slide. No error points were issued when identifying these features. The responses for band neutrophils and segmented neutrophils were combined and graded as total neutrophils.   Go to Slide 007 statistics database Return to February 1998 Cytohematology Glass Slide Event

Laboratory Data WBC 33.6 X 109/ L RBC 4.74 X 1012/ L Hemoglobin 14.2 g/dL Hematocrit 42.2% MCV 89.0 fL MCH 29.9 pg MCHC 33.6 g/dL Platelet 218 X 109 / L