Intraleukocytic Candida is Diagnostic of Pathological Candidemia

otic treatment was commenced. He later developed fever and bleeding at the stoma site. At this time his peripheral blood findings were as follows: Hb: 7.5 g/dL; WBC: 4.5 x 109/L; neutrophils: 58.8%; lymphocytes: 26.5%; eosinophils: 0.7%; monocytes: 13%; basophils: 1%; platelet count: 87 x 109/L. Peripheral blood smear showed dimorphic anemia and thrombocytopenia, as well as neutrophilic predominance with mild left shift and thrombocytopenia. In addition, the smear showed that there were many extra-leukocytic budding yeasts, along with hyphal forms of Candida (Figure 1). The budding yeasts were phagocytized by the neutrophils (Figure 2). Aerobic blood culture showed growth of C. tropicalis and C. parapsilosis following overnight incubation. The organism was observed to be growing in other body fluids as well, including sputum and urine. The patient was aggressively treated with fluconazole and later with amphotericin B; however, he died due to multiple organ failure.