We evaluated cytoplasmic vacuolization in the neutrophil as a marker of bacterial infection. We sought this phenomenon in 96 septic and nonseptic subjects. No significant differences in the extent of vacuolization were found among control patients, toxic patients without bacterial infections, and patients with bacterial infections in the absence of documented bacteremia. The extent of vacuolization was significantly greater in bacteremic patients when compared with all other groups, including patients with bacterial infection without bacteremia. However, extensive vacuolization in the neutrophils of some patients in toxic states not apparently caused by bacterial infection was noted. The phenomenon seems useful as a diagnostic test to identify bacteremia, although it may be less specific than previously thought.
(Arch Intern Med 139:675-676, 1979)