PART I. CLINICAL STUDY C. A. McKinlay, M.D.
Numerous reports are found in medical literature describing groups of cases which, on account of clinical features and blood cell changes, have been thought to be similar to and often confused with acute leukemia. Naegeli1 mentions cases of sepsis with low total leukocyte counts and relative increase in the lymphocytes, and also acute febrile affections with high absolute lymphocyte counts with atypical forms. It is pointed out that this lymphatic reaction is more confusing where there is also an absolute lymphocytosis with atypical lymphocytes. Further, with a clinical picture of fever, prostration and enlargement of lymph nodes and spleen, it may be impossible to differentiate these cases from leukemia until recovery occurs. Naegeli quotes Türk and others who report cases of angina and streptococcus sepsis with lymphatic reaction and recovery, besides cases of acute infection, such as pneumonia, scarlet fever, erysipelas, meningitis,