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Dr. Andrew Rynne

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Child with increased wbc count, decreased lymphocytes, blood in stool and no fever. What to do?

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Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 561 Questions

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Posted on Tue, 5 Feb 2013 in Infections
Question: My child Lymphocyte was a 2 today on her CBC with diff. What can cause this to go so low. She also had n/v and blood in stools. She became sick this morning. Her white blood count is 17.7 her ANC is 16.64 And her ALC is 0.35.Her SEG Neutrophil is 82 and BAND Neutrophil is 12. All other breakdown on CBC was within normal limits.Also her Prothrombin time was 11.4, her BMp everything withinlimits but Creatinine was low at 0.45 and osmolality was slightly low at 262. Stools cultures are pending. hemocult was positive but you could tell with only looking at stool. Blood was pink/bright red blood. No brown or cough like grains noted. Vomiting was lite brown to yellow in color also reminding you of mucus at times. No coughing, or congestion noted. No fever at present time. Stomach is non-tender and bowels sounds are positive x 4 quads. I have read cancer, virus, and some others can cause low count with Lymphocyte but even as a nurse I have never seen it this low. I was wondering what step I need to take next and can a virus in 8 hours time cause it to drop this low?
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Answered by Dr. Ganesh Sanap 50 minutes later
Hi

Thanks for writing in.

I would like to tell you that it is does not look like a cancerous condition.

She is most likely having bacterial or viral gastroenteral infection. Absence of fever with occult blood in stool suggests dysentery like disease. Increased white blood cell count with decreased lymphocytes is also suggestive of infection. And yes, intestinal viral infection can manifest in 8 hours time.

I suggest you to please wait for her stool culture report and maintain adequate hydration. Consult your doctor with stool culture report. He/she can prescribe appropriate antibiotic along with probiotic if symptoms do not resolve.

Hope I have answered your query. If you have any further concern, please let me know.

Regards

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