Toxic granulation

Abstract: Serial blood leucocyte counts were made on 35 ill preterm and term babies during the first 28 days of life. Ill babies with no clinical or bacteriological evidence of infection showed no changes in the blood leucocytes during the neonatal period when compared with normal babies. The changes in the blood leucocytes in babies with proven or suspected bacterial infection were an increase in the absolute values of polymorphonuclear neutrophils, an increase in the absolute values of immature neutrophils, a significant fall in polymorphonuclear neutrophils (below 1000/mm 3 ) and in eosinophils (down to 0) in very ill babies, and toxic granulation of neutrophils.

Abstract: In vitro responses of normal human neutrophils to N-formyl-methionyl-leucyl-phenylalanine (FMLP), the synthetic analog of a bacterial product, were correlated with the effects of acute bacterial infection on human neutrophils. The following perturbations in cellular functions that occurred in neutrophils obtained from patients with acute bacterial infection were mimicked in normal neutrophils pretreated with FMLP: (1) increased production of superoxide ion, as estimated by histochemical reduction of nitroblue tetrazolium (NBT); (2) increased rates of oxidative metabolism during phagocytosis of a heparin-NBT complex, latex, and opsonized zymosan; (3) enhanced response to a chemotactic stimulus, C5a; (4) increased degranulation and vacuolization of cytoplasm with neutral red supravital dye as the indicator; and (5) increased rate of membrane transport of 14C-labeled 2-deoxyglucose. Toxic granulation and elevated levels of alkaline phosphatase, which occurred in neutrophils from all of the patients with bacterial infection studied, could not be induced in control neutrophils that had been pretreated with FMLP. The results suggested that the mechanism of activation of neutrophils from many patients with acute bacterial infections could be an intravascular response to a biologically active material with properties similar to those of FMLP but that the elevated levels of alkaline phosphatase and the toxic granulation are due to different reactions.

Abstract: Context.—The number of band forms and immature neutrophils increases during acute bacterial infection. However, the determination of band counts and other neutrophil morphologic changes, such as the presence of toxic granulation, toxic vacuolization, and Dohle bodies in the cytoplasm, is labor intensive and time consuming, as it requires manual examination by an experienced medical technologist. Objective.—To investigate the value of the neutrophil volume distribution width (NDW), generated by VCS technology of the Coulter LH 750 hematology analyzer, as an additional predictor of acute infection. Design.—Total white blood cell count, percentage of neutrophils, and NDW data from 70 patients with positive blood cultures for bacteria and from 35 age-matched control subjects were retrospectively analyzed. Results.—A significant increase in the NDW was observed in the bacteremic patients compared with the controls (24.7 ± 4.5 vs 19.0 ± 1.5; P < .001). Such increase was observed even in patients with w...