Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
134 Doctors are Online

Low white cell count due to pnuemonia infection - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Infections
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   My 23-year-old daughter suffered severe pneumonia at the beginning of last December, although her bloods, including white cell count appeared normal at the time. During a post pneumonia check-up at the end of December, her white cell count was low (I don't know how low!). She had another check a week ago, and it still appeared low. She recently had an HIV check, and that was normal, so no worries there. Is it common to have a low white cell count in the months following pneumonia, or could it be a sign of something else? One thing I should add is that she is taking various meds for bi-polar disorder, eg, Lamotrigine (Lactimel) and Citalopram. I'm very worried, and would be grateful to hear what you think, and should it be followed up by a Haemotologist?
Doctor :   Hi
User :   hi
Doctor :   reading Query
User :   ok
Doctor :   How old is she?
User :   23
Doctor :   Can you give me the latest lab values?
User :   sorry, I don't have them!
Doctor :   White cells , Platelets, Hemoglobin?
Doctor :   The normal WBC count is roughly between 5000- 11,000/mm3
Doctor :   This range is taken from normal persons with out any disease
User :   when she was admitted to hospital with pneumonia, all the values were normal. It's now only the white cell count that is low, but as I said, I don't know how low. Her consultant has written to the Haemotologists, so I guess it must be low enough to get an opinion about it.
Doctor :   if she falls in this range she is fine
User :   so, can some people's white cell count be lower than others. If the lab said it was low, then I guess she doesn't fall into that range!
Doctor :   If the counts are lower than lower limit of normal, that is 5000 then she evaluation
Doctor :   Are you with me?
User :   yep
User :   what can a low white cell count indicate please?
User :   can the meds she is on cause a low WCC?
Doctor :   A low white blood cell count usually is caused by one of the following: Doctor :   1. Viral infections that temporarily disrupt bone marrow function
Doctor :   2. Congenital disorders characterized by diminished bone marrow function
Doctor :   3. Cancer or other diseases that damage bone marrow
Doctor :   4. Autoimmune disorders that destroy white blood cells or bone marrow cells
Doctor :   5. Overwhelming infections that use up white blood cells faster than they can be produce
Doctor :   6. Drugs that destroy white blood cells or damage bone marrow
User :   obviously the pneumonia was an overwhelming infection, but would her white cell count now be back to normal 3 months are the event?
Doctor :   Lamotrizine can cause low white celll counts and platelets
Doctor :   Yes 3 mo after recovery her counts should reach her base line
User :   in that case, shouldn't the lamotrigine be changed for something else? she is repeatedly getting bronchitis - she has had 3 attacks of this and one of pneumonia in the past year!
User :   I should add that she seems quite tired a lot of the time
Doctor :   I will
Doctor :   ok
User :   i guess this must be caused by the low WCC?
Doctor :   Before coming to conclusion that her white cells are low, closely watch the numbers( white cells. platelets, hemoglobin)
Doctor :   Repeat the Complete blood count again
Doctor :   And do the peripheral smear to see any abnormal looking cells and also do differential count
Doctor :   If the levels are low then talk to MD and switch to different medicines
Doctor :   And then repeat the Complete blood count
Doctor :   If the count increases after stopping the medicines, then you can say the Lamotrizine causes the low count
User :   so, if it was something eg, cancer, would other blood values look abnormal, not just the WCC?
User :   and wouldn't this have been picked up on her recent FBC?
Doctor :   WHa is FBC/
User :   Full blood count
Doctor :   Bllod cancer present with low, normal high WBC
Doctor :   it causes bleeding
Doctor :   it has low hemogloibin
User :   sorry, did you say that blood cancer normally presents with a high WBC?
Doctor :   Then on peripheral smear, you will see abnormal looking cells
Doctor :   no it can present with any numbers
Doctor :   low or high or normal
Doctor :   Do the total count
Doctor :   peripheral smaear
Doctor :   I have 1 sec
Doctor :   I need more time
Doctor :   Thank you for consulting
Doctor :   Bye
Doctor :   hi
Question is related to
Diseases and Conditions
Medical Topics
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor