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Hematology

Cold Agglutination in Mycoplasma pneumoniae Infection

Blood smear morphology in Mycoplasma pneumoniae: severe cold agglutination of red blood cells, falsely elevated MCHC, and reactive lymphocytes with uropods.

Anna Belen Anna Belen 1 min
Blood smear: lymphocyte with uropod ("Pinocchio cell") and red blood cell agglutination
Blood smear: lymphocyte with uropod ("Pinocchio cell") and red blood cell agglutination
Peripheral blood smear: clusters of agglutinated red blood cells and a reactive lymphocyte
Peripheral blood smear: clusters of agglutinated red blood cells and a reactive lymphocyte
Blood smear: pronounced cold agglutination of red blood cells and an atypical mononucleated cell
Blood smear: pronounced cold agglutination of red blood cells and an atypical mononucleated cell
Blood smear: large reactive lymphocyte among red blood cell agglomerates
Blood smear: large reactive lymphocyte among red blood cell agglomerates
Blood smear: reactive lymphocyte with elongated cytoplasm and red blood cell clusters
Blood smear: reactive lymphocyte with elongated cytoplasm and red blood cell clusters
Blood smear: atypical lymphocyte and neutrophil against a background of red blood cell agglutination
Blood smear: atypical lymphocyte and neutrophil against a background of red blood cell agglutination
Blood smear: reactive lymphocyte with characteristic cytoplasmic protrusion (Pinocchio)
Blood smear: reactive lymphocyte with characteristic cytoplasmic protrusion (Pinocchio)
Blood smear: large-plasma reactive lymphocyte in mycoplasma infection
Blood smear: large-plasma reactive lymphocyte in mycoplasma infection
Analyzer printout: false MCHC elevation to 47.4 g/dL due to agglutination
Analyzer printout: false MCHC elevation to 47.4 g/dL due to agglutination

A 36-year-old patient with Mycoplasma pneumoniae infection (IgM +) presented with “Pinocchio” cells and reactive lymphocytes. Associated cold agglutination of red blood cells and an elevated MCHC were observed.

🔬Case from the Head of the Morphology/IFT Department at A-Emek Medical Center 🇮🇱Israel - Anna Belen.

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