News : 2017 : January

Case of the Month: Under the Microscope

Emerald DoveDr. Nicole Stacy, Adjunct Professor, kicks off our new series called “Case of the Month”. Dr. Stacy joined our laboratory nearly one year ago. She has given us a huge amount of advice and training in hematology and chemistry of reptile, elasmobranch, teleost, and marine mammal species. You can see her input in several new panels. She is an avid collaborator on many of our research studies. In addition, Dr. Stacy is available for clinical case consultation.

Blood film from a common emerald dove (Chalcophaps indica)

Clinical history: Patient’s mate and patient seemed to be doing well until the morning when mate was found dead. The patient was in good body condition but depressed. Blood collection was challenging and only a small amount of blood sufficient for the preparation of 2 blood films was obtained.

Blood film evaluation:

  • WBC ESTIMATE FROM SLIDE/µL 2.1
  • IMMATURE HETEROPHILS/µL 1.05 (50%)
  • HETEROPHILS/µL 0 (0%)
  • LYMPHOCYTES/µL 0.30 (14%)
  • MONOCYTES/µL 0.74 (35%)
  • EOSINOPHILS/µL 0 (0%)
  • BASOPHILS/µL 0.02 (1%)

LEUKOCYTE MORPHOLOGY: Heterophils: marked toxicity (3+/all heterophils affected; as characterized by degranulation, vacuolation, cytoplasmic basophilia, abnormal granulation) and marked left-shift; most heterophils contained phagocytized bipolar bacilli. Most monocytes were vacuolated with phagocytized bipolar bacilli.
ERYTHROCYTE MORPHOLOGY: Red blood cell density was normal, morphology unremarkable, and no hemoparasites noted.

Figure

Figure: A, C – Vacuolated monocytes (M), A – Left shifted toxic heterophil (H) and B – Mature 2+ toxic heterophil with phagocytized bipolar bacilli. Wright-Giemsa staining.

The leukogram findings were consistent with overwhelming bacterial infection, acute systemic inflammation, and septicemia. Blood culture was recommended. Immediate treatment with antimicrobials, oxygen, and fluids was initiated. The patient recovered after 10 days of medical care, along with concurrent significant improvement in the re-check CBC two weeks after initiation of treatment.

Blood culture identified Salmonella group B. Histopathological findings of the patient’s mate included intravascular bacteremia, and peracute to acute multifocal splenic and hepatic necrosis with bacteremia. The cause of death was fulminant bacteremia. Salmonella group B was cultured from the liver. The source of Salmonella was suspected to be of food origin, although no dietary changes had been made before this event.