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What Causes Fever, Diarrhea And Nausea Inspite Of These Blood Results?

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Posted on Fri, 25 Apr 2014
Question: Hi - I need some help interpreting some recent test results, specifically a WBC w/diff and CMP. A couple of days ago I started to run a fever (102 degrees) and started having diarrhea (type 7 - watery) along with nausea. My GP ran a WBC w/diff and CMP and suspects some type of gastroenteritis. I'm a little concerned with my WBC numbers - specifically why you would see a high NE% and low LYM% along with what appears to be a lower WBC. I would have assumed that given all that was going on with me that my WBC would be elevated along with the other percentage elevations. Should I be concerned? WBC w/diff: Report Result Ref. Range Units Status Lab WBC 4.6 3.8-10.8 k/uL Final CML RBC 5.7 4.3-6.0 M/uL Final CML HGB 16.8 13.0-18.0 g/dL Final CML HCT 50.7 39.0-54.0 % Final CML MCV 89.7 79.0-100.0 fL Final CML MCH 29.7 26.8-33.2 pg Final CML MCHC 33.1 30.5-36.0 g/dL Final CML RDW 13.5 9.0-15.0 % Final CML PLT 222 150-450 k/uL Final CML NE% 84.9 50.0-80.0 % High Final CML LYM% 8.1 21.0-51.0 % Low Final CML MO% 7.0 2.0-12.0 % Final CML EO% 0.0 0.0-5.0 % Final CML BA% 0.0 0.0-2.0 % Final CML NE# 3.9 1.5-6.6 k/uL Final CML LYM# 0.4 1.5-3 .5 k/uL Low Final CML MO# 0.3 0.1-1.0 k/uL Final CML EO# 0.0 0.0-0.6 k/uL Final CML BA# 0.0 0.0-0.1 k/uL Final CML CMP: Report Result Ref. Range Units Status Lab NA 137 135-146 mmol/L Final CML K 4.0 3.5-5.3 mmol/L Final CML CL 100 95-109 mmol/L Final CML CO2 26 21-31 mmol/L Final CML AGAP 11 5-21 meq/L Final CML GLUC 110 70-105 mg/dL High Final CML BUN 16 5-25 mg/dL Final CML CR, S 1.0 0.6-1.3 mg/dL Final CML BUN/CR 15.1 6.0-25.0 Ratio Final CML CA 9.5 8.2-10.5 mg/dL Final CML T PRO 7.5 6.0-8.3 g/dL Final CML ALB 4.9 3.5-5.5 g/dL Final CML GLOB 2.6 1.5-4.5 g/dL Final CML ALB/GLOB 1.9 0.8-2.5 Ratio Final CML T BIL 1.4 0.0-1.4 mg/dL Final CML ALP 65 41-130 U/L Final CML AST 23 0-39 U/L Final CML ALT 40 0-45 U/L
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Answered by Dr. Chobufo Ditah (29 minutes later)
Brief Answer: There is no great fear here! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this pain and fever that has not been able to show any specific disease condition that is causing it. As you rightly mentioned, WBC often increase during an infection. However, there are other disease conditions like typhoid fever where you rather notice a drop in the WBC count. Also, low WBC during an infection is a sign of severity.This is to say WBC increase during an infection is not the only possibility. What happens depends on the specific infection type and severity. I have taken a look at your numbers. The WBC are in the normal range but this in no way is able to provide information on whether there has been an increased or a decreased. With a WBC of 4.6, it could be that it was at 4.0 before the infection and has now increased to 4.6. It could also be that it was higher than 4.6 but has decreased to this lower value now. This is to say it is very difficult to tell whether there is an increase in the WBC count or not during an infection when it falls within the normal range and even more so when there is no base line WBC number that we can compare this to. When there is an increase in WBC during an infection, not all the various cell types notice an increase. What cell type increases most depends on the cause of the infection. For instance, NE# would be higher in bacteria infections, LYM# in viral infections, EO# in parasitic/allergies, etc. In your case with NE predominance, the cause of this infection is most likely a bacteria. Generally, the cell type that increases most gives an idea on what infection type we should be more focused on. In all, there is no major red flag reviewing these results. Be calm and relaxed and we shall see what future blood tests return with. I hope this helps and addresses your query fully. I wish you well and feel free to request for more information and clarification if need be. Thanks. Dr. Ditah, MD.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6323 Questions

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What Causes Fever, Diarrhea And Nausea Inspite Of These Blood Results?

Brief Answer: There is no great fear here! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this pain and fever that has not been able to show any specific disease condition that is causing it. As you rightly mentioned, WBC often increase during an infection. However, there are other disease conditions like typhoid fever where you rather notice a drop in the WBC count. Also, low WBC during an infection is a sign of severity.This is to say WBC increase during an infection is not the only possibility. What happens depends on the specific infection type and severity. I have taken a look at your numbers. The WBC are in the normal range but this in no way is able to provide information on whether there has been an increased or a decreased. With a WBC of 4.6, it could be that it was at 4.0 before the infection and has now increased to 4.6. It could also be that it was higher than 4.6 but has decreased to this lower value now. This is to say it is very difficult to tell whether there is an increase in the WBC count or not during an infection when it falls within the normal range and even more so when there is no base line WBC number that we can compare this to. When there is an increase in WBC during an infection, not all the various cell types notice an increase. What cell type increases most depends on the cause of the infection. For instance, NE# would be higher in bacteria infections, LYM# in viral infections, EO# in parasitic/allergies, etc. In your case with NE predominance, the cause of this infection is most likely a bacteria. Generally, the cell type that increases most gives an idea on what infection type we should be more focused on. In all, there is no major red flag reviewing these results. Be calm and relaxed and we shall see what future blood tests return with. I hope this helps and addresses your query fully. I wish you well and feel free to request for more information and clarification if need be. Thanks. Dr. Ditah, MD.