Intraleukocytic Yeast Inclusions and Toxic Granulation Neutrophils on Peripheral Blood Smear: An Interesting Synergy between Hematology and Microbiology

The presence of yeast neutrophil inclusions was observed and discussed several times in other reports; moreover some works demonstrated how Toxic Granulation Neutrophils (TGNs) are especially helpful in predicting acute bacterial infection, while the development of candidaemia-related TGNs was rarely described and in-depth. We describe two occasional findings of neutrophil inclusions and marked TGNs respectively due to Candida tropicalis and Candida guillermondi on peripheral blood smear. We proved how the microscopic observation of marked toxic granulations can afford to suspect a systemic microbial infection without the potential to discriminate between bacterial or fungal infections.