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The page below is a sample from the LabCE course Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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A CBC and reticulocyte count are ordered on a 10-year-old African-American male who was brought to the emergency department with rapid, shallow breathing and fever. The results are shown below.

ParameterPatient ResultReference Interval
WBC28.0 x 109/L3.2- 9.8 x 109/L
RBC3.88 x 1012/L4.50 - 5.70 x 1012/L
Hemoglobin10.0 g/dL13.6 - 17.2 g/dL
MCV82 fL80 - 110 fL
2311 - 14.5
8.0%0.5 - 1.5%

The image on the right is a representative field from the peripheral blood smear. What cells are indicated by the arrows in this smear?

Please select the single best answer