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Diagnosed with mono. CBC done for NRBC2 and reactive lymph. What does the finding suggest?

DOCTOR OF THE MONTH - Jun 2013
Jun 2013
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Practicing since : 2005
Answered : 2219 Questions
Question
How would you interpret Reactive Lymph at 33.0 !!! and NRBC2 at 2.0!!! ?
CBC results

Dear Doctor, Kindly confirm by email that you have recd this question and I can provide more details. Thank You.
Posted Wed, 15 May 2013 in Cancer
 
 
Answered by Dr. Sushil Kumar Sompur 5 hours later
Hi there ~

I understand your concern for your sone and I need more information depending on which I can try to give you the right answers. I hope this helps. Take care and have a lovely day!
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with mono. CBC done for NRBC2 and reactive lymph. What does the finding suggest? 20 hours later
Thanks Doctor,My son haS been diagnosed with mono and I was wondering within that context how significant the cbc readings are: 33.0!!! Reactive Lymps and NRCB2 at 2.0!!! Can you kindly speak the implications of these readings ? Are these typical in mono patients or are they outstanding in some way ? Especially the NRBC ?Secondly, he was given Morphine and Oxycodone in the ER and had trouble breathing after that. Do these medications further impact respiiratory issues when the tonsils are at 4+ and obstructed ?How serious is 4+ tonsil enlargement in a mono patient ? Patient Age 20 with Mono.
Is that measurement of 4+ alarming or typically seen ?
Does Epiglottits show up in a standard strep-type of throat culture or respiratory culture ? Is it common or occcur concurently with mono ?

Thank you so much for your kind reply.
 
 
Answered by Dr. Sushil Kumar Sompur 3 hours later
Hi there ~

Thank you for your questions and my slight delay in response. Well, yes, your sons high lymphocyte counts, both reactive and NRBC may be attributed to his having mononucleocytosis infection. I would not read much into this as they will get better as your son gets better as well. Also, hydrating him well may be a potential solution. I also think that morphine and oxycodone given in the ER may have led to respiratory issues as a higher than normal dose or a sensitive subject may have respiratory depression from these analgesic opioid medications. An additional contributing factor to his respiratory difficulties may be that he was having enlarged tonsils. Getting the tonsils out by consulting an ENT surgeon i.e. an otorhinolaryngologist is the way to go. It is not alarming as long as it is not obstructing his breathing during the day or night. You might have to change his posture during night when he sleep and has difficulty breathing till his tonsils and mononucleosis get better. On a different note, epiglottitis may occur commonly with these infections as viral infections decrease immunity and result in a greater potential for bacterial infection. I hope this answered your questions and relieved your anxiety. Please consult your son's pediatrician for any acute issues. I hope you are following your doctor's instructions for your son otherwise.

Take care and have a lovely day!
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with mono. CBC done for NRBC2 and reactive lymph. What does the finding suggest? 22 hours later
Thank you doctor,
Your answers have been very helpful.
One final question if you could kindly help further. Does Epiglottitis typically show up on a the standard throat culture or respiratory culture given when mono is suspected, or does it require a seperate test to diagnose, such as a blood culture or imaging scan ?
In other words, what tests are used to confirm or diagnose Epiglottits ?
Thank you again !
 
 
Answered by Dr. Sushil Kumar Sompur 1 hour later
Hi there ~

Epiglottitis is mostly a clinical diagnosis and x-ray lateral and a-p views of the neck will show the diagnosis. However a throat culture would give you exactly what kind of infection is going on as well as what the culture is sensitive to in terms of antibiotics, so as to prescribe the best possible antibiotic. I hope this helps. Take care and have a lovely day!
Above answer was peer-reviewed by
 
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