Differential Diagnosis for Elevated White Blood Count with Right Lower Chest Pain/Upper Quadrant
- Single Most Likely Diagnosis + Pneumonia: This is a common condition that can cause both elevated white blood cell count (indicating infection or inflammation) and right lower chest pain, especially if the pneumonia is localized to the right lower lobe. The pain can sometimes be referred to the upper quadrant due to the proximity of the diaphragm to the liver and gallbladder.
- Other Likely Diagnoses + Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant pain and an elevated white blood cell count. The pain can sometimes radiate to the lower chest area. + Pyelonephritis: An infection of the kidney can cause flank pain, which might be perceived as lower chest pain, and would certainly cause an elevated white blood cell count. + Pulmonary Embolism: While not typically causing an elevated white blood cell count by itself, if there's an associated infection or if the embolism leads to infarction, it could result in an elevated count. The pain can be pleuritic and localized to one area, potentially the right lower chest.
- Do Not Miss Diagnoses + Appendicitis: Although classically presenting with right lower quadrant pain, an elevated white blood cell count, and potential for chest pain if the appendix is retrocecal, it's crucial not to miss due to the risk of perforation and peritonitis. + Perforated Visculitis or Ulcer: A perforation in the gastrointestinal tract can lead to peritonitis, causing severe pain and a high white blood cell count. The pain can be diffuse or localized, depending on the site of perforation. + Liver Abscess: A collection of pus in the liver can cause right upper quadrant pain, fever, and an elevated white blood cell count. It's a serious condition that requires prompt treatment.
- Rare Diagnoses + Hepatic Infarction: Rarely, a hepatic infarction can occur due to various reasons like hepatic artery thrombosis, leading to right upper quadrant pain and elevated white blood cell count. + Diaphragmatic Abscess: An abscess of the diaphragm can cause chest pain and an elevated white blood cell count, though it's a rare occurrence. + Empyema: A collection of pus in the pleural space can cause chest pain, fever, and an elevated white blood cell count. While not extremely rare, it's less common than pneumonia but serious enough to be considered.