Vacuolated neutrophils can predict serious infection

Abstract

We reviewed 148 cases in which vacuolated neutrophils were recognized on examination of peripheral blood smears by the medical technologist and confirmed by the pathologist. There was a high correlation between the presence of vacuolated neutrophils and one or more positive microbiologic cultures. Of interest was the observation that vacuolated neutrophils occurred in serious infections from various sites, not necessarily the blood. Among blood cultures, Staphylococcus aureus was the most common organism. In other types of cultures, S aureus and Pseudomonas aeruginosa were the most common organisms, followed by Escherichia coli. As a quality assurance measure, we propose that vacuolated neutrophils be designated as a 'panic value,' requiring notification of the attending physician.