From the Guidelines
The patient's blood test results indicate an elevated white blood cell count, primarily due to increased neutrophils, suggesting an inflammatory or infectious process, most likely bacterial, as supported by the study 1 which found that an elevated total band count and increased percentage of neutrophils had high likelihood ratios for detecting documented bacterial infection. The blood test results show an elevated white blood cell count (WBC) of 13.9 and 12.2 x10E3/uL (normal range 3.4-10.8), indicating leukocytosis. This is primarily due to increased neutrophils (absolute count 9.1 and 8.5 x10E3/uL, above the normal range of 1.4-7.0), suggesting neutrophilia. Key findings include:
- Elevated WBC count: 13.9 and 12.2 x10E3/uL
- Elevated absolute neutrophil count: 9.1 and 8.5 x10E3/uL
- Elevated lymphocytes in the first sample: 3.7 x10E3/uL
- Elevated hematocrit in the second sample: 52.4% The study 1 found that an elevated total band count (>1500/mm3) had a likelihood ratio of 14.5 for detecting documented bacterial infection, and an increase in the percentage of neutrophils (>90%) had a likelihood ratio of 7.5. Given these findings, it is essential to consider a bacterial infection as a potential underlying cause and to correlate the laboratory results with the patient's clinical symptoms and possibly conduct further investigations to determine the source of the infection.
From the Research
Blood Test Results
The provided blood test results show various parameters, including:
- White blood cell count (WBC): 13.9 and 12.2 x10E3/uL, which is within the normal range of 3.4-10.8 x10E3/uL 2
- Red blood cell count (RBC): 5.60 and 5.77 x10E6/uL, which is within the normal range of 4.14-5.80 x10E6/uL
- Hemoglobin: 16.5 and 17.3 g/dL, which is within the normal range of 13.0-17.7 g/dL
- Hematocrit: 50.4 and 52.4 %, which is within the normal range of 37.5-51.0 %
- Mean corpuscular volume (MCV): 90 and 91 fL, which is within the normal range of 79-97 fL
- Mean corpuscular hemoglobin (MCH): 29.5 and 30.0 pg, which is within the normal range of 26.6-33.0 pg
- Mean corpuscular hemoglobin concentration (MCHC): 32.7 and 33.0 g/dL, which is within the normal range of 31.5-35.7 g/dL
- Red cell distribution width (RDW): 14.3 and 13.7 %, which is within the normal range of 11.6-15.4 %
- Platelets: 246 and 233 x10E3/uL, which is within the normal range of 150-450 x10E3/uL
Neutrophil Count
The absolute neutrophil count is 9.1 and 8.5 x10E3/uL, which is higher than the normal range of 1.4-7.0 x10E3/uL 2. This could indicate a potential infection or inflammation.
Neutrophil Function
Neutrophils play a crucial role in the immune system, and their function can be affected by various factors, including viral infections 3, 4. They can contribute to antiviral defense by trapping and inactivating viruses, but overactivation can lead to tissue damage.
Immune Response
The immune response to viral infections involves the activation of various immune cells, including neutrophils 5, 4. Neutrophils can restrict viral replication and diffusion through phagocytosis, degranulation, and the release of neutrophil extracellular traps.
Potential Causes
The elevated neutrophil count could be caused by various factors, including: