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Pathological Case of the Month

Jeffrey C. Murray, MD; Mary V. Gresik, MD; Baruti M. Serabe, MD; Tracy L. Harpel, MD; Murali Chintagumpala, MD; Donald H. Mahoney Jr, MD
Arch Pediatr Adolesc Med. 1995;149(9):1033-1034. doi:10.1001/archpedi.1995.02170220099016.
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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,


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