Can a high Total Leukocyte Count (TLC) of 18,000 be attributed to a urinary tract infection, given the presence of 10-12 pus cells in the urine routine test?

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Differential Diagnosis for High TLC Count and Urine Infection

  • Single most likely diagnosis:
    • Urinary Tract Infection (UTI): The presence of pus cells in the urine (10-12) strongly suggests a urinary tract infection, which can cause an elevated Total Leukocyte Count (TLC) as the body responds to the infection.
  • Other Likely diagnoses:
    • Respiratory Tract Infection: An infection in the respiratory tract, such as pneumonia or bronchitis, could also lead to an elevated TLC count.
    • Gastrointestinal Infection: Infections like gastroenteritis can cause an increase in white blood cell count.
    • Skin or Soft Tissue Infection: Infections of the skin or soft tissues can also elevate the TLC count.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Sepsis: Although less likely, sepsis is a life-threatening condition that can cause an elevated TLC count and must be considered, especially if the patient shows signs of systemic infection.
    • Pyelonephritis: An upper urinary tract infection that can lead to severe complications if not treated promptly.
    • Appendicitis: Although the primary symptom is abdominal pain, an elevated TLC count can be seen, and appendicitis is a surgical emergency.
  • Rare diagnoses:
    • Leukemia: A type of blood cancer that can cause an elevated TLC count, though it would typically be much higher than 18,000.
    • Lymphoma: Certain types of lymphoma can cause an increase in white blood cell count.
    • Chronic Inflammatory Conditions: Conditions like rheumatoid arthritis or inflammatory bowel disease can cause chronic elevations in TLC count, though the clinical context would typically suggest these diagnoses.

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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