Ultrastructural observations in an alcoholic patient with post-surgical pseudomonas infection

Gram negative bacteria were seen in the peripheral blood and within the neutrophils of a patient with bacteremic shock secondary to Pseudomonas aeruginosa infection. By electron microscopy, bacteria were present either in vacuoles or in the cytoplasm of neutrophils. When seen in the cytoplasm, they were surrounded by amorphous material which most probably represented fused lysosomal granules. In both cases, the microorganisms appeared morphologically normal. The presumption is that there was a pre-existing defect of neutrophilic lysosomal formation or function. These findings indicate the importance of studying neutrophil morphology and function in patients with persistent infections.