Florid erythrophagocytosis on the peripheral smear.

Erythrophagocytosis is a relatively rare observation on blood smears. It has been reported in auto immune hemolytic anemias and sporadically in few other conditions. Here, we report a case of florid erythrophagocytosis with severe anemia following a viral infection in an 18-year-old girl. Her complete blood count (CBC) revealed hemoglobin of 3.6 gm/dl and a hematocrit of 10%. The peripheral smear showed erythrophagocytosis by neutrophils and rosetting of erythrocytes around neutrophils. The direct Coombs test and direct Donath- Landsteiner tests were positive.