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Babesiosis: problems in diagnosis using autoanalyzers.
American Journal of Clinical Pathology
|April 1, 1985
Summary
Babesia species, a cause of persistent fevers, were missed by automated differentials but found on review of blood slides. This highlights potential diagnostic challenges with automated blood analysis.
Area of Science:
- Hematology
- Infectious Diseases
- Parasitology
Background:
- Waldenstrom's macroglobulinemia can present with prolonged, non-specific symptoms like fever and sweats.
- Automated hematology analyzers are crucial for routine blood cell analysis.
Observation:
- A patient with Waldenstrom's macroglobulinemia experienced persistent fevers and sweats for 2.5 years.
- Automated differentials repeatedly failed to identify intracellular inclusions in red blood cells (RBCs).
- Microbiology analysis confirmed the presence of Babesia species in the patient's blood.
Findings:
- A review of blood smears revealed Babesia species within RBCs on all examined slides.
- The automated analyzer had screened these slides previously without detecting the parasitic inclusions.
- This indicates a failure of the automated system to identify Babesia in infected RBCs.
Implications:
- Automated hematology analyzers may miss parasitic infections like Babesiosis.
- Delayed or missed diagnosis of Babesiosis can lead to prolonged illness and potential complications.
- Careful review of peripheral blood smears remains essential for diagnosing certain infections, especially when symptoms are persistent and unexplained.