Yumizen H500 Hematology Analyzer
July 2025 (PDF for print)
Patient Demography: Female, 21 years old
Symptoms: The patient presented with fever and throat pain.
Diagnosis: Infectious Mononucleosis (IM)
Microscopic Review: Neutrophils 26%, Lymphocytes 60%, Monocytes 12%, Epsinophil 1%, Basophil 1%. The lymphocytes are moderate to large-sized with dispersed chromatin and mildly basophilic, agranular, abundant cytoplasm, characteristic of Infectious Mononucleosis (IM).
How Yumizen Can Assist: On the DIFF scattergram, in the ALY marked location, a cluster of cells on microscopy identified as moderate to large reactive lymphocytes. The alarms of ALY & LYM/MONO by the analyzer also give a suspicion to look for viral infection like Infectious Mononucleosis. The morphology of the lymphocytes is typical of infectious mononucleosis (IM), also called “Downey Cells,” which has been confirmed by further ELISA testing for Epstein–Barr virus (EBV).
Note to Follow: The platelet count in Infectious Mononucleosis (IM) is almost always normal, along with within-range WBC, which helps to differentiate it from Dengue for exclusion of IM.
Large reactive lymphocytes in IM: with dispersed chromatin and abundant, mildly basophilic, agranular cytoplasm
ELISA for EBV: VCA IgG positive +++, (VCA) UREA positive ++, CA (IgM) negative, EA (IgG) positive, NA (IgG) positive
This clinical case has been provided by Biswadip Hazarika, MD, Hematology Department, Batra Hospital and Medical Research Centre, Delhi, India.
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