PEDIATRICS Vol. 74 No. 5 November 1984, pp. 823-827
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Degenerative Changes in Neutrophils: An Indicator of Bacterial Infection

Cheng-Hurd Liu MD1, Carol Lehan MD1, Michael E. Speer MD1, Donald J. Fernbach MD1, and Arnold J. Rudolph MD1

1 From the Sections of Neonatology and Research Hematology, Department of Pediatrics, Baylor College of Medicine, Houston

A review was made of 195 peripheral blood smears of 157 neonates who required sepsis work-up in the first month of life. Degenerative changes of neutrophils including vacuolization and toxic granulation were observed frequently in infants with culture-proven bacterial sepsis. Of 21 peripheral blood smears from 20 neonates subsequently proven to have bacterial infection, 17 had vacuolization present in the neutrophils for a sensitivity of 81%, a specificity of 93%, and a positive predictive accuracy of 59%. Toxic granulation changes in neutrophils showed similar results. This simple test can be performed easily in all hospitals; it does not require special laboratory facilities. The test appears to provide a valuable adjunct in the early detection of neonatal bacterial infection.

Key Words: neonatal sepsis • neutrophils • vacuolization • toxic granulation

Submitted on October 28, 1983
Accepted on February 1, 1984