From the Guidelines
Elevated neutrophils, also known as neutrophilia, typically indicate an active infection, inflammation, or stress in the body, and the most appropriate course of action is to consult with a healthcare provider to investigate the underlying cause through additional tests and treat the root cause rather than the neutrophil count itself. The condition can be caused by various factors including bacterial infections, physical or emotional stress, certain medications, inflammatory conditions, and sometimes cancer or leukemia.
When evaluating elevated neutrophils, it is essential to consider the overall clinical context, including the patient's medical history, symptoms, and physical examination findings. According to the study by 1, the risk of bacterial, fungal, and viral infections is elevated in patients with cancer, who may experience immunosuppression resulting from cancer treatment and sometimes from the disease itself.
The study by 1 highlights the importance of a complete blood cell count with differential in evaluating fever and infection in older adults, and notes that an elevated total band count, an increase in the percentage of neutrophils, and a left shift can indicate a high probability of an underlying bacterial infection.
In terms of management, the guidelines by 1 and 1 recommend that patients with febrile neutropenia should be assessed by an infectious disease physician or clinical microbiologist, and antifungal therapy should be considered in cases of persistent fever despite neutrophil recovery.
Key points to consider in the management of elevated neutrophils include:
- Investigating the underlying cause through additional tests such as a complete blood count with differential, blood cultures, or imaging studies
- Treating the root cause rather than the neutrophil count itself
- Considering antifungal therapy in cases of persistent fever despite neutrophil recovery
- Evaluating the patient's overall clinical context, including medical history, symptoms, and physical examination findings.
It is crucial to prioritize the patient's morbidity, mortality, and quality of life when managing elevated neutrophils, and to consult with a healthcare provider to determine the best course of action.
From the Research
Neutrophils Elevated
- Neutrophils are a type of white blood cell that plays a crucial role in the immune system, particularly in fighting infections and inflammation 2.
- Elevated neutrophil counts can be a sign of infection, inflammation, or other underlying medical conditions.
- However, the provided studies do not directly address the topic of elevated neutrophils, but rather focus on neutropenia, which is a condition characterized by low neutrophil counts.
Neutropenia
- Neutropenia is a common hematological finding, and severe neutropenia is a well-known risk factor for susceptibility to bacterial infections 3.
- Ceftriaxone-induced neutropenia is a rare and severe adverse effect of the drug, which usually resolves in one to three weeks following the cessation of ceftriaxone and the administration of granulocyte colony-stimulating factor (G-CSF) 4.
- Ceftaroline use has been independently associated with neutropenia, and prolonged ceftaroline use is an independent risk factor for developing mild neutropenia 5.
- Intravenous ceftriaxone treatment is associated with a fall in neutrophils, which can be predicted by routine baseline blood indices 6.
Predictors of Neutropenia
- Baseline haematocrit, red blood cell count, mean corpuscular volume, total iron binding capacity, calcium ion concentration, and alkaline phosphatase have been identified as predictors of neutropenia associated with intravenous ceftriaxone treatment 6.
- The neutrophil count can be predicted by a multifactor linear regression model that takes into account various baseline blood indices 6.