"Case 11"
Case 11

Case 11
History:
14 years old male brought to emergency room.
In good health until 24 hours prior to admission, when parents noted fever, progressive lethargy, and dark red urine.
No known family history of anemia, jaundice, gallstones, or splenectomy.

Case 11
Physical Exam:
Lethargic, pallor with jaundiced skin and scleral icterus.
No splenomegaly and hepatomegaly.
Temperature of 102°F.

Slide 4

CBC
RBC 1.28 x 10[12]/L
HGB 4.5 g/dL
HCT 11.4 %
MCV 89.1 fL
MCH 35.2 pg
MCHC 39.4 g/dL
WBC 27.8 x 10[9]/L(N seg 65 % N myelo 1 L 31 M 3 E 0 B 0 NRBC/100 WBC 2)
PLT 425 x 10[9]/L

"Question"
Questions

What morphologic alterations are seen in this blood smear field?

What further laboratory studies, if any, are indicated?

What is the most likely diagnosis?