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Have had repeated tonsillitis. CBC showed elevated neutrophil level. How serious is this?

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My primary doctor has referred me to a hem/onc doctor. I've had repeated tonsillitis (3 times in 5 months). She drew a CBC the third time which showed WBC 15.9, neutrophils 11.4, monocytes 1.2. Gave me a shot of antibiotics and a round of Augmentin. Three weeks later she redrew CBC..WBC 18.7, neutrophils 12.4, monocytes 1.4...I'm a nurse and can't get off work for nearly a month to see a hem/onc doctor. How urgently should I been seen? Do you think it's okay for me to wait a month?
Posted Fri, 22 Mar 2013 in Blood Disorders
Answered by Dr. Robert Galamaga 2 hours later
Hello and thank you for sending your question.

Your question is a very good one and I will work on providing you with some information and recommendations.

From the information you have submitted it looks like on your complete blood count that your neutrophil level is significantly elevated. This will raise your total white blood cell count as well. The neutrophils in your case are likely fighting infection. If you had recent tonsillitis requiring antibiotics then this is most likely the reason why your white blood cell count is elevated.

It would be reasonable to check your complete blood count again but I don't think this is an emergency. If you're otherwise feeling well again this is most likely a residual effect of your body eliminating the infection.

I think it is reasonable for you to visit with the hematologist but I don't think it is an emergency at this time. The hematologist will make sure that your blood cells look normal under the microscope. Hematologist will also likely request another complete blood count again to document improvement of your total white blood cell count.
If for some reason the white blood cell count remains elevated additional testing might be requested.

Again I suspect that what we are seeing is a reactive process related to your tonsillitis.

Thanks again for sending your question. Please let me know if you have any additional concerns that you would like to discuss.


Dr. Galamaga
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