Differential Diagnosis for Elevated Neutrophils

Single Most Likely Diagnosis

• Chronic Infection: A persistent infection, such as a dental abscess, sinusitis, or a skin infection, could cause a prolonged elevation in neutrophils. The body's ongoing response to the infection would lead to increased production of neutrophils.

Other Likely Diagnoses

• Chronic Inflammation: Conditions like rheumatoid arthritis, inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis), or chronic obstructive pulmonary disease (COPD) can cause a sustained increase in neutrophil production due to the body's inflammatory response.
• Medication Effect: Certain medications, such as corticosteroids, can cause an increase in neutrophil count as a side effect.
• Smoking: Smoking is known to increase neutrophil counts, possibly due to the body's response to chronic inflammation in the lungs.

Do Not Miss Diagnoses

• Leukemia (e.g., Chronic Myeloid Leukemia or Chronic Lymphocytic Leukemia): Although less common, leukemia must be considered in the differential diagnosis due to its potential severity and the need for early intervention. An elevated white blood cell count, including neutrophils, can be a presenting feature.
• Sepsis or Systemic Infection: A severe, systemic infection could cause a significant elevation in neutrophils. It's crucial to identify and treat such conditions promptly to prevent serious complications or death.

Rare Diagnoses

• Myeloproliferative Neoplasms (e.g., Polycythemia Vera, Essential Thrombocytosis): These are rare disorders of the bone marrow that can lead to an overproduction of blood cells, including neutrophils.
• Chronic Neutrophilic Leukemia: A rare form of leukemia characterized by a sustained increase in mature neutrophils in the blood.
• Familial Neutrophilia: A rare, inherited condition that causes an elevated neutrophil count without an underlying infection or inflammation.

Each of these diagnoses should be considered and investigated based on the patient's clinical presentation, medical history, and additional diagnostic tests as necessary.