What is the significance of elevated White Blood Cell (WBC) count and Immature Granulocytes Absolute, with concurrent neutrophilia and mild anemia, in a 2-year-old patient?

From the Guidelines

The patient's elevated white blood cell count of 13.8 K/mcL, with a significant increase in absolute neutrophil count to 9.15 K/mcL, strongly suggests a bacterial infection, which requires immediate medical attention to prevent potential complications and improve quality of life. The blood test results indicate an active inflammatory or infectious process in the body, with the elevated neutrophils pointing towards a likely bacterial infection, as supported by the study published in Clinical Infectious Diseases 1. The presence of immature granulocytes, with a count of 0.15 K/mcL, also indicates that the bone marrow is responding to the infection by releasing newer cells.

Key Findings:

• Elevated white blood cell count (WBC) of 13.8 K/mcL, above the reference range of 4.6-10.2 K/mcL
• Increased absolute neutrophil count of 9.15 K/mcL, above the normal range of 1.80-7.70 K/mcL
• Slightly elevated immature granulocyte count of 0.15 K/mcL, above the normal range of 0.00-0.10 K/mcL
• All other parameters, including red blood cell counts, hemoglobin, hematocrit, and platelet counts, are within normal ranges

Clinical Implications:

The study published in Clinical Infectious Diseases 1 highlights the importance of considering the total white blood cell count and differential in diagnosing bacterial infections. The findings of this study, combined with the patient's blood test results, suggest that a bacterial infection is likely present. Prompt medical evaluation and treatment are essential to prevent potential complications, such as sepsis, and to improve the patient's quality of life. The patient's medical history and physical examination should be carefully evaluated to identify the underlying cause of the elevated white blood cell count, and appropriate diagnostic tests and treatments should be initiated accordingly.

From the Research

White Blood Cell Count

• The patient's white blood cell count is 13.8 K/mcL, which is higher than the reference range of 4.6 - 10.2 K/mcL 2.
• A high white blood cell count can be caused by various factors, including infections, inflammatory processes, physical stress, and emotional stress 2.
• The patient's neutrophil count is 66.3%, which is within the reference range of 38.1 - 75.5% 2.
• The patient's lymphocyte count is 26.2%, which is within the reference range of 17.9 - 49.6% 2.

Red Blood Cell Count

• The patient's red blood cell count is 4.32 M/mcL, which is within the reference range of 3.74 - 5.34 M/mcL.
• The patient's hemoglobin level is 13.5 g/dL, which is within the reference range of 12.0 - 16.0 g/dL.
• The patient's hematocrit level is 41.3%, which is within the reference range of 34.3 - 47.9%.

Platelet Count

• The patient's platelet count is 219 K/mcL, which is within the reference range of 142 - 424 K/mcL.
• The patient's mean platelet volume (MPV) is 10.5 FL, which is within the reference range of 6.2 - 12.1 FL.

Infection and Sepsis

• The patient's white blood cell count and neutrophil percentage can be used to predict bloodstream infection, but these values are not clinically reliable in predicting bloodstream infection 3.
• Obtaining blood cultures before antibiotic administration is recommended, as antibiotic therapy can reduce the detection of pathogens in blood cultures 4.
• Procalcitonin (PCT) is a useful biomarker for diagnosing and prognosticating infection or sepsis, and it can be used in combination with white blood cell count and C-reactive protein (CRP) to guide antibiotic therapy 5.