What are the causes of elevated neutrophil (white blood cell) count, also known as neutrophilia?

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From the Guidelines

Elevated neutrophils typically indicate an active infection, inflammation, or stress in the body, and treatment should focus on addressing the underlying cause rather than the elevated neutrophil count itself. The normal range for neutrophils is 1,500-8,000 cells per microliter, and an excess of this range is often a normal immune response to bacterial infections, but can also be caused by viral infections, inflammatory conditions, stress, certain medications, and rarely, blood disorders or cancer 1. Common causes of elevated neutrophils include:

  • Bacterial infections, which require appropriate antibiotics
  • Viral infections, which are often self-limiting
  • Inflammatory conditions like rheumatoid arthritis, treated with anti-inflammatory medications
  • Stress
  • Certain medications
  • Rarely, blood disorders or cancer

If you have elevated neutrophils, it is essential to consult a healthcare provider for proper evaluation, which may include a complete blood count, physical examination, and possibly additional tests to determine the cause 1. Neutrophils are the body's first line of defense against infections, particularly bacterial ones, so their elevation is often a normal immune response. However, persistent neutrophilia without an obvious cause requires medical attention to rule out serious conditions. In patients with cancer, especially those with HIV, the risk of opportunistic infections is elevated, and prophylaxis should be considered based on the patient's HIV status and cancer treatment 1. Treatment should always prioritize addressing the underlying cause of elevated neutrophils, rather than the elevated count itself, to improve patient outcomes and reduce morbidity and mortality.

From the Research

Elevated Neutrophil Count

Elevated neutrophil count, also known as neutrophilia, can be caused by various factors, including:

  • Infections, such as sepsis or abscesses
  • Inflammatory conditions, such as chronic obstructive pulmonary disease (COPD) or rheumatoid arthritis
  • Medications, such as glucocorticosteroids (GCS) 2
  • Other medical conditions, such as leukemia or lymphoma

Causes of Neutrophilia

Some studies have investigated the causes of neutrophilia, including:

  • The use of GCS, which can cause leukocytosis and neutrophilia 2
  • The role of neutrophils in chronic inflammatory diseases, such as COPD and atherosclerosis 3, 4, 5
  • The effects of antibiotics, such as ceftriaxone and meropenem, which can cause neutropenia, a decrease in neutrophil count 6

Effects of Neutrophilia

Neutrophilia can have various effects on the body, including:

  • Increased risk of infection and sepsis
  • Tissue damage and inflammation
  • Impaired lung function in conditions such as COPD 3, 5
  • Potential therapeutic targets for the treatment of chronic inflammatory diseases 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Neutrophils in chronic inflammatory diseases.

Cellular & molecular immunology, 2022

Research

The neutrophil in chronic obstructive pulmonary disease.

American journal of respiratory cell and molecular biology, 2013

Research

Neutropenia Induced by Ceftriaxone and Meropenem.

European journal of case reports in internal medicine, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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