Early Candida parapsilosis Sepsis Detection Using Sysmex XN-3000 Hematological Analyzer: Case Report

Special Article - Red Blood Cells

Thromb Haemost Res. 2019; 3(3): 1030.

Early Candida parapsilosis Sepsis Detection Using Sysmex XN-3000 Hematological Analyzer: Case Report

De Azambuja AP*, Spiri BS, Ferreira D, Trenenpohl J, Bonfim CMS and Comar SR

Universidade Federal do Paraná, Brazil

*Corresponding author: Ana Paula de Azambuja, Universidade Federal do Paraná, Brazil

Received: September 03, 2019; Accepted: October 03, 2019; Published: October 10, 2019

Abstract

Candida parapsilosis sepsis is a rare but fatal disease affecting all age groups, commonly caused by fungal surface contamination of medical devices such as central venous catheters [1]. These infections are relevant and increasing problem in debilitated and immunosuppressed patients, which can evolve from a superficial non-life-threatening disease to a clinical picture of severe sepsis with multiorgan dissemination [2].

An etiological diagnosis of catheter-related candidemia requires the yeasts isolation from both peripheral and catheter blood samples and takes three or more days in obtaining definite culture results, so the average time before an etiological therapy can be administered usually involves waiting more than 98 h, depending on the species of Candida [2].

We describe a young child case where leukogram scatter diagram in XN- 3000 hematology analyzer (Sysmex, Japan) allowed viewing of a distinct blue cloud in erytroblast canal (NRBC), allowing clinicians to start empiric antifungal therapy long before the blood culture results were available.

Case Report

Male, 4 months, diagnosed with Severe Combined Immunodeficiency Syndrome (SCID) due to recurrent infections, perianal dermatitis and disseminated hyperchromic skin lesions, with undetectable TRECs and Krec’s and flow cytometry with T+, Band NK+ lymphocytes, absence of naïve LT (CD45RA) and increased memory LT (CD45RO). The etiological diagnosis of Ommen’s Syndrome was done and the patient received haploidentical Hematopoietic Stem Cell Transplantation (HSCT) with donor father.

In eleven day after bone marrow transplantation, a routine complete blood count and white blood cell differentials performed on XN-3000 hematology analyzer (Sysmex, Japan) showed a blue cloud in the erythroblast canal (NRBC) suspected of Candida sp. in the dispersion diagram of the leukogram (Figure 1 and 2). Microscopic review of May-Grünwald- Giemsa stained peripheral blood smears performed by experienced hematologists and microbiologist and a positive blood culture done in Bactec FX Top (Becton Dickinson) increased suspicion for candidemia. The agar chocolate culture for identification of the species (VITEK - bioMérieux Brasil), confirmed the presence of C. parapsilosis.

Citation: De Azambuja AP, Spiri BS, Ferreira D, Trenenpohl J, Bonfim CMS and Comar SR. Early Candida parapsilosis Sepsis Detection Using Sysmex XN-3000 Hematological Analyzer: Case Report. Thromb Haemost Res. 2019; 3(3): 1030.