PMC6855031_01
Peripheral blood smear and bone marrow studies. (a) Peripheral blood smear shows severe neutropenia with no neutrophils seen in this field (hematoxylin and eosin stain; x400), (b) bone marrow biopsy with normal cellularity, increased megakaryocytes (blue arrows), and severe decrease in neutrophils (hematoxylin and eosin stain; x400), and (c) bone marrow smear displays severely decreased segmented granulocytes and increased blasts (blue arrows; Wright-Giemsa stain x400).
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fig1
On day three, marrow examination was done and reported a 40-60% cellularity with myeloid hypoplasia (myeloid to erythroid precursor ratio of 0.5 : 1) and increased blasts (Figure 1).
Daily leukocyte trend throughout the admission in the hospital.
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fig2
Despite a slowly rising leukocyte count, he continued to spike fevers for the first seven days of admission; on day nine of admission, his leukocyte count had normalized (Figure 2).