261:
55:
159:
171:
280:
372:
252:
411:
From the thick smear, an experienced microscopist can detect all parasites they encounter. Microscopic diagnosis can be difficult because the early trophozoites ("ring form") of all four species look identical and it is never possible to diagnose species on the basis of a single ring form; species
406:
allow the microscopist to screen a larger volume of blood and are about eleven times more sensitive than the thin film, so picking up low levels of infection is easier on the thick film, but the appearance of the parasite is much more distorted and therefore distinguishing between the different
149:
to disperse the blood over the slide's length. The aim is to get a region, called a monolayer, where the cells are spaced far enough apart to be counted and differentiated. The monolayer is found in the "feathered edge" created by the spreader slide as it draws the blood forward.
352:, are also visible on the blood smear. Modern complete blood count analyzers can provide an automated white blood cell differential, but they have a limited ability to differentiate immature and abnormal cells, so manual examination of the blood smear is frequently indicated.
415:
The biggest pitfall in most laboratories in developed countries is leaving too great a delay between taking the blood sample and making the blood smears. As blood cools to room temperature, male gametocytes will divide and release
392:
The preferred and most reliable diagnosis of malaria is microscopic examination of blood smears, because each of the four major parasite species has distinguishing characteristics. Two sorts of blood smear are traditionally used.
748:
J. Gerard; E. Lebas; A. Godon; O. Blanchet; F. Genevieve; A. Mercat; M. Zandecki (2007). "Free and intracellular bacteria on peripheral blood smears: an uncommon situation related to an adverse prognosis".
440:
is left for several hours in EDTA, the buildup of acid in the sample will cause the parasitised erythrocytes to shrink and the parasite will roll up, simulating the appearance of
238:
After staining, the monolayer is viewed under a microscope using magnification up to 1000 times. Individual cells are examined and their morphology is characterized and recorded.
59:
Two push-type peripheral blood smears suitable for characterization of cellular blood elements. Left smear is unstained, right smear is stained with Wright-Giemsa stain.
1302:
1694:
1699:
903:
460:. Romanowsky stain or a variant stain is usually used. Some laboratories mistakenly use the same staining pH as they do for routine haematology blood films (
1646:
1355:
121:
and then stained in such a way as to allow the various blood cells to be examined microscopically. Blood smears are examined in the investigation of
1684:
691:
540:
510:
1295:
400:
are similar to usual blood films and allow species identification, because the parasite's appearance is best preserved in this preparation.
1580:
876:
1689:
1631:
1365:
896:
318:
1668:
269:
The left image shows a microscopic view of a normal adult blood film, while the right image shows a blood film from a patient with
1592:
1727:
1288:
479:
1494:
1621:
1379:
329:
482:) are nonmicroscopic diagnostic options for the laboratory that may not have appropriate microscopy expertise available.
1616:
1177:
889:
54:
1538:
1504:
1350:
301:
Microscopic examination of the shape, size, and coloration of red blood cells is useful for determining the cause of
1626:
1214:
1477:
332:. The white blood cell differential can reveal abnormalities in the proportions of white blood cell types, such as
1587:
1384:
1202:
1039:
985:
355:
Blood smear examination is the preferred diagnostic method for certain parasitic infections, such as malaria and
1464:
1239:
260:
196:. The fixative is essential for good staining and presentation of cellular detail. After fixation, the slide is
1234:
997:
270:
158:
1548:
1360:
428:
will rupture and merozoites invading erythrocytes will mistakenly give the appearance of the accolé form of
170:
1482:
1374:
1345:
1136:
680:
John P. Greer; Sherrie L. Perkins (December 2008). "Chapter 1: Examination of the blood and bone marrow".
306:
32:
1088:
465:
1679:
1658:
1434:
1249:
779:
475:
377:
279:
371:
182:
Closeups of the feathered edge of blood smears. The pale middle band of the gradient is the monolayer.
1760:
1609:
1575:
1446:
1396:
1322:
1093:
314:
291:
189:
1459:
219:. Wright-Giemsa combination stain is also a popular choice. These stains allow for the detection of
1604:
1244:
1172:
1098:
1029:
532:
Linné & Ringsrud's
Clinical Laboratory Science: Concepts, Procedures, and Clinical Applications
529:
Mary Louise
Turgeon (23 March 2015). "Chapter 11: Principles and practice of clinical hematology".
203:
Routine analysis of blood in medical laboratories is usually performed on blood films stained with
686:. Vol. 1 (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. pp. 5–9.
1765:
1408:
1403:
1062:
469:
310:
295:
197:
1737:
1510:
1229:
1224:
836:
758:
730:
687:
662:
595:
577:
536:
506:
349:
325:
208:
65:
1636:
1533:
1528:
1471:
1454:
1155:
1077:
826:
818:
720:
652:
585:
569:
558:"Purpose and Criteria for Blood Smear Scan, Blood Smear Examination, and Blood Smear Review"
235:
often use other specialized stains to aid in the differential diagnosis of blood disorders.
220:
204:
118:
420:: these are long sinuous filamentous structures that can be mistaken for organisms such as
1421:
614:
251:
232:
1219:
1732:
1641:
1570:
1391:
1340:
1182:
962:
921:
590:
557:
345:
284:
224:
831:
806:
1754:
1560:
1543:
1487:
1440:
1067:
992:
445:
145:
A blood smear is made by placing a drop of blood on one end of a slide, and using a
1722:
1653:
1429:
1207:
1057:
946:
941:
936:
386:
382:
337:
333:
212:
36:
81:
681:
530:
500:
1520:
1499:
1194:
1103:
1016:
980:
970:
417:
126:
75:
1717:
1597:
1553:
1335:
1330:
1314:
1311:
1164:
1131:
1113:
1011:
356:
341:
134:
122:
657:
640:
581:
359:. Rarely, bacteria may be visible on the blood smear in patients with severe
1021:
1006:
573:
425:
216:
854:
Hempelmann E, Wilson RJ (1982). "Immunoprecipitation of malarial enzymes".
762:
734:
666:
599:
840:
375:
Blood smears showing various developmental stages of the malaria parasite
17:
1280:
1265:
1141:
975:
822:
228:
193:
1663:
556:
Gulati, Gene; Song, Jinming; Dulau Florea, Alina; Gong, Jerald (2013).
453:
449:
130:
881:
709:"Laboratory diagnosis of infections due to blood and tissue parasites"
91:
360:
302:
294:
in order to investigate abnormal results or confirm results that the
340:, as well as the presence of abnormal cells such as the circulating
725:
708:
290:
Blood smear examination is usually performed in conjunction with a
370:
328:
can be determined from the blood smear. This is known as a manual
278:
114:
283:
Variations of red blood cell shape on blood film, overall termed
457:
1284:
885:
456:
are used. The anticoagulant that causes the least problems is
125:(blood) disorders and are routinely employed to look for blood
27:
This article is about the microscope slide. For films named
499:
Denise
Harmening (2009). "Chapter 31: Hematology methods".
461:
321:
result in characteristic abnormalities on the blood film.
464:
6.8): malaria blood films must be stained at pH 7.2, or
412:
identification is always based on several trophozoites.
348:. Qualitative abnormalities of white blood cells, like
478:
capture procedures (rapid diagnostic tests such as the
188:
The slide is left to air dry, after which the blood is
780:"CDC - DPDx - Diagnostic Procedures - Blood Specimens"
1710:
1519:
1419:
1321:
1258:
1193:
1163:
1154:
1124:
1076:
1050:
955:
929:
920:
74:
64:
47:
535:(7th ed.). Elsevier Mosby. pp. 321–323.
502:Clinical Hematology and Fundamentals of Hemostasis
641:"Automated blood cell counts: state of the art"
424:. If the blood is kept at warmer temperatures,
35:. For films with excessive blood and gore, see
1695:aPTT-based activated protein C resistance test
1700:ETP-based activated protein C resistance test
1296:
897:
524:
522:
8:
613:Choladda Vejabhuti Curry (14 January 2015).
1303:
1289:
1281:
1160:
926:
904:
890:
882:
200:to distinguish the cells from each other.
53:
1356:Mean corpuscular hemoglobin concentration
830:
724:
656:
589:
192:to the slide by immersing it briefly in
1685:Ristocetin-induced platelet aggregation
1647:Activated protein C–protein C inhibitor
491:
774:
772:
645:American Journal of Clinical Pathology
639:Buttarello, M; Plebani, M (Jul 2008).
324:The proportions of different types of
44:
505:(5th ed.). F. A. Davis Company.
7:
1728:Nitro blue tetrazolium chloride test
1690:Activated protein C resistance test
407:species can be much more difficult.
87:
33:Blood (disambiguation) § Films
25:
1581:Dilute Russell's viper venom time
1366:Red blood cell distribution width
807:"Laboratory diagnosis of malaria"
805:Warhurst DC, Williams JE (1996).
319:microangiopathic hemolytic anemia
42:Stained blood on microscope slide
1593:Calibrated automated thrombogram
444:. This problem is made worse if
259:
250:
169:
157:
480:malaria antigen detection tests
1622:Coagulation activation markers
1495:Erythrocyte sedimentation rate
683:Wintrobe's Clinical Hematology
1:
1632:Thrombin–antithrombin complex
1380:White blood cell differential
562:Annals of Laboratory Medicine
330:white blood cell differential
1617:Overall hemostatic potential
751:Annales de biologie clinique
713:Clinical Infectious Diseases
1539:Partial thromboplastin time
1505:Monocyte distribution width
1351:Mean corpuscular hemoglobin
298:has flagged as unreliable.
1782:
1478:Hemoglobin electrophoresis
707:Jon E. Rosenblatt (2009).
615:"Differential Blood Count"
26:
1627:Prothrombin fragments 1+2
1588:Thrombin generation assay
1385:Absolute neutrophil count
1203:Hypersegmented neutrophil
1110:Hemoglobin precipitation
1040:Hereditary stomatocytosis
986:Hereditary elliptocytosis
88:
52:
1235:Critical green inclusion
1026:Sickle cell/drepanocyte
998:Hereditary spherocytosis
658:10.1309/EK3C7CTDKNVPXVTN
271:chronic myeloid leukemia
1549:Activated clotting time
1361:Mean corpuscular volume
967:Membrane abnormalities
574:10.3343/alm.2013.33.1.1
472:dots will not be seen.
1483:Sickle solubility test
1375:White blood cell count
1346:Red blood cell indices
1137:Red cell agglutination
877:Blood photomicrographs
389:
307:iron deficiency anemia
287:
107:peripheral blood smear
1680:Von Willebrand factor
1659:Euglobulin lysis time
1598:ST Genesia-based test
476:Immunochromatographic
378:Plasmodium falciparum
374:
282:
242:Clinical significance
176:Wright-Giemsa stained
1673:-antiplasmin complex
1610:Thrombodynamics test
1576:Ecarin clotting time
1465:Kleihauer–Betke test
1397:Mean platelet volume
1341:Red blood cell count
1323:Complete blood count
1240:Alder–Reilly anomaly
1094:Basophilic stippling
823:10.1136/jcp.49.7.533
315:megaloblastic anemia
305:. Disorders such as
292:complete blood count
1605:Thromboelastography
1215:Pelger–Huët anomaly
1173:Reactive lymphocyte
1099:Pappenheimer bodies
1030:Sickle cell disease
129:, such as those of
117:smeared on a glass
113:is a thin layer of
1435:Total blood volume
1409:Reticulocyte index
1404:Reticulocyte count
1063:Hypochromic anemia
390:
311:sickle cell anemia
296:automated analyzer
288:
233:Hematopathologists
1748:
1747:
1738:Immunophenotyping
1511:Osmotic fragility
1278:
1277:
1274:
1273:
1230:Toxic vacuolation
1225:Toxic granulation
1156:White blood cells
1150:
1149:
1089:Howell–Jolly body
786:. 4 November 2020
693:978-0-7817-6507-7
542:978-0-323-22545-8
512:978-0-8036-1732-2
350:toxic granulation
326:white blood cells
205:Romanowsky stains
99:
98:
16:(Redirected from
1773:
1637:Fibrinopeptide A
1534:Prothrombin time
1529:Clotting factors
1472:Hemoglobinopathy
1455:Fetal hemoglobin
1305:
1298:
1291:
1282:
1245:Jordans' anomaly
1161:
1078:Inclusion bodies
927:
906:
899:
892:
883:
864:
863:
851:
845:
844:
834:
802:
796:
795:
793:
791:
776:
767:
766:
745:
739:
738:
728:
719:(7): 1103–1108.
704:
698:
697:
677:
671:
670:
660:
636:
630:
629:
627:
625:
610:
604:
603:
593:
553:
547:
546:
526:
517:
516:
496:
466:SchĂĽffner's dots
263:
254:
221:white blood cell
173:
161:
119:microscope slide
92:edit on Wikidata
84:
57:
45:
31:or similar, see
21:
1781:
1780:
1776:
1775:
1774:
1772:
1771:
1770:
1751:
1750:
1749:
1744:
1723:Blood viscosity
1706:
1672:
1642:Fibrin monomers
1515:
1460:Apt–Downey test
1447:Red cell volume
1422:red blood cells
1420:Other tests of
1415:
1317:
1309:
1279:
1270:
1254:
1189:
1146:
1120:
1072:
1046:
951:
922:Red blood cells
916:
910:
873:
868:
867:
853:
852:
848:
804:
803:
799:
789:
787:
778:
777:
770:
747:
746:
742:
706:
705:
701:
694:
679:
678:
674:
638:
637:
633:
623:
621:
612:
611:
607:
555:
554:
550:
543:
528:
527:
520:
513:
498:
497:
493:
488:
381:, stained with
369:
277:
276:
275:
274:
266:
265:
264:
256:
255:
244:
231:abnormalities.
186:
185:
184:
183:
179:
178:
177:
174:
166:
165:
162:
143:
95:
80:
60:
43:
40:
23:
22:
15:
12:
11:
5:
1779:
1777:
1769:
1768:
1763:
1753:
1752:
1746:
1745:
1743:
1742:
1741:
1740:
1733:Flow cytometry
1730:
1725:
1720:
1714:
1712:
1708:
1707:
1705:
1704:
1703:
1702:
1697:
1687:
1682:
1677:
1676:
1675:
1670:
1666:
1661:
1651:
1650:
1649:
1644:
1639:
1634:
1629:
1619:
1614:
1613:
1612:
1602:
1601:
1600:
1595:
1585:
1584:
1583:
1578:
1573:
1571:Reptilase time
1563:
1558:
1557:
1556:
1551:
1546:
1541:
1536:
1525:
1523:
1517:
1516:
1514:
1513:
1508:
1502:
1497:
1492:
1491:
1490:
1485:
1480:
1469:
1468:
1467:
1462:
1452:
1451:
1450:
1444:
1438:
1426:
1424:
1417:
1416:
1414:
1413:
1412:
1411:
1401:
1400:
1399:
1392:Platelet count
1389:
1388:
1387:
1382:
1372:
1371:
1370:
1369:
1368:
1363:
1358:
1353:
1338:
1333:
1327:
1325:
1319:
1318:
1310:
1308:
1307:
1300:
1293:
1285:
1276:
1275:
1272:
1271:
1269:
1268:
1262:
1260:
1256:
1255:
1253:
1252:
1247:
1242:
1237:
1232:
1227:
1222:
1217:
1212:
1211:
1210:
1199:
1197:
1191:
1190:
1188:
1187:
1186:
1185:
1183:Russell bodies
1175:
1169:
1167:
1158:
1152:
1151:
1148:
1147:
1145:
1144:
1139:
1134:
1128:
1126:
1122:
1121:
1119:
1118:
1117:
1116:
1108:
1107:
1106:
1101:
1096:
1091:
1085:Developmental
1082:
1080:
1074:
1073:
1071:
1070:
1065:
1060:
1054:
1052:
1048:
1047:
1045:
1044:
1043:
1042:
1034:
1033:
1032:
1024:
1019:
1014:
1009:
1004:
1003:
1002:
1001:
1000:
990:
989:
988:
978:
973:
965:
963:Poikilocytosis
959:
957:
953:
952:
950:
949:
944:
939:
933:
931:
924:
918:
917:
911:
909:
908:
901:
894:
886:
880:
879:
872:
871:External links
869:
866:
865:
846:
797:
768:
740:
726:10.1086/605574
699:
692:
672:
631:
605:
548:
541:
518:
511:
490:
489:
487:
484:
446:anticoagulants
409:
408:
401:
368:
365:
346:acute leukemia
285:poikilocytosis
268:
267:
258:
257:
249:
248:
247:
246:
245:
243:
240:
225:red blood cell
209:Wright's stain
181:
180:
175:
168:
167:
163:
156:
155:
154:
153:
152:
147:spreader slide
142:
139:
97:
96:
89:
86:
85:
78:
72:
71:
68:
62:
61:
58:
50:
49:
41:
24:
14:
13:
10:
9:
6:
4:
3:
2:
1778:
1767:
1764:
1762:
1759:
1758:
1756:
1739:
1736:
1735:
1734:
1731:
1729:
1726:
1724:
1721:
1719:
1716:
1715:
1713:
1709:
1701:
1698:
1696:
1693:
1692:
1691:
1688:
1686:
1683:
1681:
1678:
1674:
1667:
1665:
1662:
1660:
1657:
1656:
1655:
1652:
1648:
1645:
1643:
1640:
1638:
1635:
1633:
1630:
1628:
1625:
1624:
1623:
1620:
1618:
1615:
1611:
1608:
1607:
1606:
1603:
1599:
1596:
1594:
1591:
1590:
1589:
1586:
1582:
1579:
1577:
1574:
1572:
1569:
1568:
1567:
1566:animal enzyme
1564:
1562:
1561:Bleeding time
1559:
1555:
1552:
1550:
1547:
1545:
1544:Thrombin time
1542:
1540:
1537:
1535:
1532:
1531:
1530:
1527:
1526:
1524:
1522:
1518:
1512:
1509:
1506:
1503:
1501:
1498:
1496:
1493:
1489:
1488:Mentzer index
1486:
1484:
1481:
1479:
1476:
1475:
1473:
1470:
1466:
1463:
1461:
1458:
1457:
1456:
1453:
1448:
1445:
1442:
1441:Plasma volume
1439:
1436:
1433:
1432:
1431:
1428:
1427:
1425:
1423:
1418:
1410:
1407:
1406:
1405:
1402:
1398:
1395:
1394:
1393:
1390:
1386:
1383:
1381:
1378:
1377:
1376:
1373:
1367:
1364:
1362:
1359:
1357:
1354:
1352:
1349:
1348:
1347:
1344:
1343:
1342:
1339:
1337:
1334:
1332:
1329:
1328:
1326:
1324:
1320:
1316:
1313:
1306:
1301:
1299:
1294:
1292:
1287:
1286:
1283:
1267:
1264:
1263:
1261:
1257:
1251:
1248:
1246:
1243:
1241:
1238:
1236:
1233:
1231:
1228:
1226:
1223:
1221:
1218:
1216:
1213:
1209:
1206:
1205:
1204:
1201:
1200:
1198:
1196:
1192:
1184:
1181:
1180:
1179:
1176:
1174:
1171:
1170:
1168:
1166:
1162:
1159:
1157:
1153:
1143:
1140:
1138:
1135:
1133:
1130:
1129:
1127:
1123:
1115:
1112:
1111:
1109:
1105:
1102:
1100:
1097:
1095:
1092:
1090:
1087:
1086:
1084:
1083:
1081:
1079:
1075:
1069:
1068:Polychromasia
1066:
1064:
1061:
1059:
1056:
1055:
1053:
1049:
1041:
1038:
1037:
1035:
1031:
1028:
1027:
1025:
1023:
1020:
1018:
1015:
1013:
1010:
1008:
1005:
999:
996:
995:
994:
991:
987:
984:
983:
982:
979:
977:
974:
972:
969:
968:
966:
964:
961:
960:
958:
954:
948:
945:
943:
940:
938:
935:
934:
932:
928:
925:
923:
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811:J Clin Pathol
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651:(1): 104–16.
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38:
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30:
19:
1654:Fibrinolysis
1565:
1430:Blood volume
1220:Döhle bodies
1208:Arneth count
1195:Granulocytes
1058:Anisochromia
1036:Stomatocyte
947:Microcytosis
942:Macrocytosis
937:Anisocytosis
912:
859:
856:Protozoology
855:
849:
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788:. Retrieved
783:
757:(1): 87–91.
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418:microgametes
414:
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404:Thick smears
403:
397:
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387:Giemsa stain
383:Wright stain
376:
354:
338:eosinophilia
334:neutrophilia
323:
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289:
237:
213:Giemsa stain
202:
187:
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110:
106:
102:
100:
37:slasher film
28:
1761:Blood tests
1521:Coagulation
1500:Haptoglobin
1315:blood tests
1178:Smudge cell
1165:Lymphocytes
1104:Cabot rings
1017:Schistocyte
981:Elliptocyte
971:Acanthocyte
790:20 February
784:www.cdc.gov
442:P. malariae
398:Thin smears
342:blast cells
141:Preparation
103:blood smear
76:MedlinePlus
48:Blood smear
1755:Categories
1718:Blood film
1554:Fibrinogen
1336:Hematocrit
1331:Hemoglobin
1312:Hematology
1250:Left shift
1132:Haemoconia
1114:Heinz body
1012:Echinocyte
993:Spherocyte
913:Blood film
568:(1): 1–7.
486:References
357:babesiosis
135:filariasis
111:blood film
18:Blood film
1766:Pathology
1669:Plasmin-α
1022:Degmacyte
1007:Dacrocyte
582:2234-3806
426:schizonts
217:Diff-Quik
164:Unstained
127:parasites
1474:testing
1266:Auer rod
1142:Rouleaux
976:Codocyte
915:findings
763:17264045
735:19691431
667:18550479
619:Medscape
600:23301216
448:such as
438:P. ovale
434:P. vivax
422:Borrelia
344:seen in
229:platelet
207:such as
194:methanol
66:ICD-9-CM
1664:D-Dimer
841:8813948
624:12 June
591:3535191
454:citrate
450:heparin
367:Malaria
198:stained
131:malaria
1051:Colour
862:: 637.
839:
832:500564
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588:
580:
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470:James'
361:sepsis
303:anemia
227:, and
82:003665
1711:Other
1507:(MDW)
1449:(RCV)
1437:(TBV)
1259:Other
1125:Other
956:Shape
432:. If
215:, or
190:fixed
115:blood
90:[
29:Blood
1443:(PV)
930:Size
837:PMID
792:2022
759:PMID
731:PMID
688:ISBN
663:PMID
626:2019
596:PMID
578:ISSN
537:ISBN
507:ISBN
468:and
458:EDTA
385:and
336:and
317:and
133:and
70:90.5
827:PMC
819:doi
721:doi
653:doi
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586:PMC
570:doi
452:or
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521:^
462:pH
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