Topic outline

  • Patient with shock and multiorgan failure

    Presenter: Anna Merino (ES)

    About the presenter:

    Anna Merino González MD, PhD is a Senior consultant of cytology unit of Hemotherapy-Hemostasis Department in Hospital Clinic of Barcelona. Her main research interests are: morphology and identification of hematopoietic progenitor cells using flow cytometry, external quality programs in peripheral blood smear and automatic classification of abnormal peripheral blood cells. She has written 2 monographies and more than 80 articles in scientific journals with H-index 17. She is also a corresponding member of EFLM Working Group Distant Education and e-Learning.

    Moderator: Daniel Rajdl (CZ)


    A 66-year-old woman was admitted to our hospital with shock and multiorgan failure. She was resident in the United States, in a rural area of New Jersey. She had been on vacation in Europe for 3 weeks and had suffered fever and chills for 1 week, and nausea, vomiting and abdominal pain for 2 days.On admission she showed respiratory, hepatic and renal failure, anemia, lymphopenia, thrombocytopenia, high lactate dehydrogenase (3500 IU/L; normal: 250–450) and negative direct and indirect Coombs test.The peripheral blood (PB) film revealed the diagnosis of the patient. Some interesting images of the morphological findings in blood cells will be discussed during the presentation. It will be useful for the participants to learn about the differential diagnosis in this special case, since the abnormalities that we found in blood cells can be easily confused with those of other more frequent disease. Diagnosis can be challenging and therefore knowledge of the distinguishing clinical features and epidemiology of these diseases is important. In addition to morphology, an adequate clinical history is important for speedy and accurate diagnosis.