Differential Diagnosis for Neutrophilia

To provide a comprehensive differential diagnosis, I'll need to consider the patient's symptoms, medical history, and physical examination findings. However, based on the laboratory results provided, here's a preliminary differential diagnosis:

• Single Most Likely Diagnosis
  • Bacterial Infection: The elevated absolute neutrophil count (ANC) of 16.2 suggests a bacterial infection, which is a common cause of neutrophilia. The patient's white blood cell count (WBC) of 18K and the presence of neutrophilia support this diagnosis.
• Other Likely Diagnoses
  • Acute Inflammation: Conditions such as acute pancreatitis, cholecystitis, or appendicitis can cause neutrophilia due to the inflammatory response.
  • Chronic Myeloid Leukemia (CML): Although less likely, CML can present with neutrophilia, and the elevated platelet count of 400 could be seen in this condition.
  • Stress Response: Severe stress, such as from trauma, surgery, or severe illness, can cause neutrophilia due to the release of stress hormones like cortisol and adrenaline.
• Do Not Miss Diagnoses
  • Sepsis: A life-threatening condition that requires prompt recognition and treatment. Although the patient's WBC count is elevated, sepsis can present with a wide range of white blood cell counts, and the presence of neutrophilia increases the suspicion.
  • Neutrophilic Leukemia: Such as acute myeloid leukemia (AML) or other myeloproliferative neoplasms, which can present with neutrophilia and require urgent evaluation and treatment.
• Rare Diagnoses
  • Myeloproliferative Neoplasms: Conditions like polycythemia vera, essential thrombocythemia, or primary myelofibrosis can cause neutrophilia, although they are less common.
  • Familial Neutrophilia: A rare genetic condition characterized by persistent neutrophilia without an underlying infection or inflammation.

To further refine this differential diagnosis, I would like to ask the following questions:

1. What are the patient's symptoms, and how long have they been present?
2. Is there a history of recent travel, exposure to infectious agents, or underlying medical conditions?
3. What are the patient's vital signs, including temperature, blood pressure, and oxygen saturation?
4. Have any imaging studies or cultures been performed to evaluate for infection or inflammation?
5. Is there a family history of hematologic disorders or myeloproliferative neoplasms?