Question

A patients complete blood count result is found to have 68% segmented neutrophils and 10% bands. This patient is likely experiencing which of the following?

-a severe bacterial infection

-a severe viral infection

-excessive bleeding

-anemia

Answer 1

The cells that are present in the blood are red blood cells, white blood cells, and platelets. A complete blood count (CBC) is a blood test to identify number and type of these cells in the blood.

The normal reference range for various white blood cells are given below.

WBCs	Per cubic. Millimeter	Percent (%)
Total WBC count	5,000-10,000	100
Lymphocytes	1,000-4,000	20-40
Neutrophils(Segmented)	2,500-6,000	40-60
Neutrophils(band)	0-500	0-5
Neutrophils (juvenile)	0-100	0-1
Myelocytes	0	0
Eosinophils	50-300	1-3
Basophils	0-100	0-1
Monocytes	200-800	4-8

Neutrophilia is the presence of high percentage of neutrophils in the blood. Some health conditions in which neutrophilia can be seen ,are :

· Bacterial infection,

· Inflammation (non-infectious)

· injury

· surgery

· smoking

· Excessive stress

· Over exercise

· Use of steroids

· Myocardial infarction

· Leukemia (chronic myeloid type )

Answer to the question - a severe bacterial infection

Rationale

Neutrophils are the plentiful and primary white blood cells that readily react to an infection with bacteria , especially pyogenic bacteria and bone marrow will produce high amount of neutrophils to fight against infection. Hence neutrophilia is commonly seen in a bacterial infection .Segmented neutrophils and band neutrophils are 68% (normal :40-60%) and 10% (normal:0-5%) respectively in the patient .

Other options are wrong because

· Viral infection- Neutrophilia is generally not seen in viral infections. Itmay increase or decrease the white cell count, especially lymphocytes.

· Excessive bleeding - it cannot increase neutrophil count, but reduces the number blood cells.

· Anemia – Neutrophilia is not seen in anemia. But some conditions like megaloblastic anemias can cause neutropenia (reduced number of neutrophils) due to less-effective bone marrow production .