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Neutrophil aggregation in sepsis

Neutrophil aggregation in sepsis
#00066243
Author: Sumitha Baskaran; Madhura Jogwar; Metropolis healthcare limited
Category: Laboratory Hematology > Basics of automated cell counts   > Causes of inaccurate white blood cell counts > Non-lysis of red cells --> falsely high WBC and lymphocyte counts   > Neutrophil aggregation  
Published Date: 02/19/2026

A 72-year-old male with diabetes, hypertension, chronic kidney disease, ischemic heart disease (post-PTCA), and interstitial lung disease presented with hypotension and hypoglycemia. Peripheral smear (Leishman stain,×100,×400 and ×1000 oil immersion) revealed marked neutrophilic leucocytosis with shift to left, prominent neutrophil aggregates, normocytic red cells with mild anisocytosis, adequate platelets.

Neutrophil aggregation may occur due to EDTA-induced in vitro adhesion or in vivo neutrophil activation in systemic inflammatory states such as sepsis.

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