This is a higher power view of this same smear demonstrating a neutrophil that is filled with Toxoplasma gondii tachyzoites (blue arrow).
There are a few free organisms in this image as well, indicated by the red arrows. The typical morphology for toxoplasma organisms is lavender cytoplasm with a red granular cluster in the center of each parasite.
This patient was negative for Toxoplasma gondii prior to a transplant but had received 15 units of blood products due to cytopenia.
It is believed that a donor for one of the transfused units had been exposed to Toxoplasma gondii either through cats or contaminated food and had transient circulating Toxoplasma gondii in his or her blood when the donation was made.
In this case, the recipient was profoundly immunocompromised, which led to rapidly developing systemic disease.
