Reprint requests to Veterans Administration Medical Center/11, 2002 Holcombe Blvd, Houston, TX 77030 (Dr Young).
Edited by Roxanne K. Young, Associate Editor.
A college student in previous good health presented with recent onset of fever, rigors, headache, and nuchal rigidity. A routine peripheral blood smear showed many intraleukocytic and extracellular cocci and diplococci (Figure). The organisms appeared purple in the Wright-stained preparation, but the presence of a high-grade bacteremia was unmistakable. The diagnosis of meningococcemia was confirmed by a lumbar puncture, which revealed gram-negative diplococci, and later Neisseria meningitidis group B was grown from both cerebrospinal fluid and blood.
Microorganisms are infrequently visualized in peripheral blood films,1 although it has been reported that examination of the buffy-coat layer is sometimes helpful in making an early diagnosis of septicemia.2 In most instances only rare organisms are seen within phagocytic cells of the buffy coat, but their presence is strong evidence of bacteremia (or fungemia). When large numbers of organisms are present, it is important to rule out pseudobacteremia caused by contaminated
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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