No PMNs seen

The final lab report on the synovial fluid that was aspirated on October 24th, which came in during the night, was terse:

Gram Stain: No PMNs seen. No organisms seen.

Culture: No growth 5 days. No Anaerobes isolated.

Clearly a case in which no news is good news: no organisms and no anaerobes is a good thing; the lab work was undertaken, after all, in the hope that nothing would be found. Surgery to replace my right hip, now scheduled for the 14th, can go on.

But what are PMNs?

PMN stands for polymorphonuclear (neutophils, i.e. neutrophilic granuloctyes) — by the way, polymorphonuclear is a nice line of trochaic tetrameter, which ought to be workable into a larger piece of poetry — which are a sign of bacterial infection. No PMNs detected, no infection present.

Wikipedia on neutrophil granuloctyes:

The name neutrophil derives from staining characteristics on hematoxylin and eosin (H&E) histological or cytological preparations. Whereas basophilic white blood cells stain dark blue and eosinophilic white blood cells stain bright red, neutrophils stain a neutral pink.

… Neutrophils are normally found in the blood stream. During the beginning (acute) phase of inflammation, particularly as a result of bacterial infection, environmental exposure, and some cancers, neutrophils are one of the first-responders of inflammatory cells to migrate towards the site of inflammation.

… With the eosinophil and the basophil, [neutrophils] form the class of polymorphonuclear cells, named for the nucleus’s multilobulated shape (as compared to lymphocytes and monocytes, the other types of white cells).

Basophils — basophilic granulocytes — are susceptible to staining by basic (that is, alkaline) dyes, while eosinophils — eosinophilic granulocytes — are susceptible to staining by acid dyes. (Note the clipping-style abbreviations in neutrophil, basophil, and eosinophil.)

(This is an impressive case in which technical terminology is truly necessary, at least if you want to understand what lies behind a lab result of, basically, “no bad guys around”.)

Next step: a bunch of blood tests and an EKG, to be done in a few hours from now, as preface to a pre-operative physical exam on the 9th.

(Entertainingly, the K in EKG for electrocardiogram comes from the German.)


4 Responses to “No PMNs seen”

  1. Allison Wright Says:

    Yes, but you are still in pain.

    • arnold zwicky Says:

      Oh my, yes. These are awful days, filled with pain, exhaustion, and looming depression. Trying to keep Vicodin at safe levels, while avoiding debilitating stress. But sitting in chairs is comfortable, and crafting postings is therapeutic.

      • Allison Wright Says:

        I hope you find an appropriate treatment which brings lasting relief soon, and I am sorry you have to endure the medical merry-go-round. By the way, one cannot detect your pain in your other blog posts (in case you were wondering).

  2. Dee Ell Says:

    Thanks for writing this stuff, with your good explanations. Yours is the first page I found with a good explanation, strangely.
    I haven’t much truck with the medical establisment up until now, and I’ve just gotten a culture back with “no PMNs”, yay.

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