LEUCOCYTOSIS

Ask the Following Questions:

1. Is the red cell count and platelet elevated? This would suggest polycythemia vera or hemoconcentration.
2. Are the neutrophils increased? This would suggest a bacterial infection, leukemia, or corticosteroid therapy.
3. Is there an increased percentage of lymphocytes? This would suggest a viral infection, infectious mononucleosis, or lymphatic leukemia.
4. Is there an increased percentage of monocytes? Obviously, in this situation one should consider a monocytic leukemia, but severe infections can also present this picture.
5. Is the percentage of eosinophils increased? Allergic disorders (asthma, etc.) and parasitic disease present this picture.
6. Is the percentage of basophils increased? This would suggest chronic myelogenous leukemia and other blood dyscrasias.

DIAGNOSTIC WORKUP

On physical examination one should look for a source of infection. Prostatic abscess and tubo-ovarian abscess are often missed. If there is a massive splenic enlargement, the possibility of myeloid metaplasia must be considered. Cultures should be taken of all body fluids and an unspun drop of urine looked at under the microscope. If there is motile bacteria, it is safe to say that there are more than 100,000 colonies/cc, which is a clear indication of a UTI. A sedimentation rate, chemistry panel, blood and bone marrow smear examination, serial blood cultures, blood smears for malarial parasites, and Monospot test all have their place in the workup, but a hematology consult is wise before undertaking more expensive tests.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Leukocytosis

Read excerpts from these other book chapters related to Leukocytosis:

Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Leukocytosis

• Back to symptom: Leukocytosis: Introduction (review 73 causes)
• Next Book Extract About Leukocytosis: Leukocytosis (In A Page: Pediatric Signs and Symptoms)
• All Book Extracts: All Online Book Extracts for Leukocytosis

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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