Intracytoplasmic granulocytic morulae counts on confirmed cases of ehrlichiosis/anaplasmosis in the Northeast

Am J Clin Pathol. 2014 May;141(5):683-6. doi: 10.1309/AJCP6Q2BOKYALDYZ.

Abstract

Objectives: To characterize the number of granulocytes needed to count on peripheral smear to identify diagnostic anaplasmosis morulae.

Methods: Retrospective case study where the peripheral smears of 14 confirmed cases of anaplasmosis were examined. The granulocytes were counted up to 100 and 200 until a morula was identified. The mean counts of three pathologists were calculated to determine the minimum number of granulocytes needed to count for identifying diagnostic morulae.

Results: Morulae were identified before a count of 100 granulocytes in 11 (78.6%) cases and between 100 and 200 granulocytes in 3 (21.4%) cases. All 14 (100%) cases had morulae identified before counting 200 granulocytes.

Conclusions: Peripheral smears are a useful, cost-effective, and time-effective tool for diagnosing anaplasmosis. In positive cases, diagnostic morulae can be identified with a count of 200 granulocytes.

Keywords: Human granulocytic anaplasmosis; Morula; Peripheral blood smear.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anaplasmosis / blood*
  • Anaplasmosis / diagnosis
  • Ehrlichiosis / blood*
  • Ehrlichiosis / diagnosis
  • Female
  • Granulocytes / cytology*
  • Humans
  • Leukocyte Count / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • United States