Clinical usefulness of polymorphonuclear leukocyte vacuolization in predicting septicemia in febrile children

Vacuolization of the polymorphonuclear leukocyte (PMN) has generally been regarded as an indication of bacterial infection and has been particularly useful in diagnosing septicemia. In an effort to predict septicemia, peripheral blood smears from 69 febrile children were examined and systematically scored for severity of vacuolization. Thirteen children had remarkable vacuolization compared to the others. These 13 included only five children with bacterial illness and only one of the seven children with septicemia. The finding that PMN vacuolization was neither diagnostic of septicemia nor predictive of bacterial infection suggests that the specificity of the link between vacuoles and bacteremia needs to be reassessed.