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What Does ESR Of 44 And Leucocytes 61% Indicate?
Question: My child 5 years of age is suffering from fever since last 10 days. Fever is intermittent, sometime in day for about 4 to 5 hrs or at night.
CBC/CRP --> Showing ESR as 44 mm/hr and Leucocytes 61%
CRP --> Positive
CBC/CRP --> Showing ESR as 44 mm/hr and Leucocytes 61%
CRP --> Positive
Brief Answer:
Child seems to have bacterial infection requiring treatment with antibiotic
Detailed Answer:
Thanks for asking on HealthcareMagic.
CRP or C-Reactive protein and ESR or Erythrocyte sedimentation rate are two parameters which indicate that there is some infective or inflammatory reaction going on in the body. The leucocytes of white blood cells, in particular the neutrophils, act as the policing system of the body. It would have been better if you had mentioned the exact count but a rise in leucocyte count indicates an infection.
In summary, your child is likely to be suffering from a bacterial infection and requires to be treated with antibiotics. Whether oral antibiotics would be fine or intravenous antibiotics need to be administered (after getting the child admitted), is a decision that I am not in a position to make since I cannot assess the child clinically. I think accepting your doctor's judgement would be a better idea in this regard.
Since the fever is lasting for 10 days or more, I would also insist on getting certain blood tests done to rule out typhoid fever. Please talk to your doctor about the same.
Hope that helps.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
Child seems to have bacterial infection requiring treatment with antibiotic
Detailed Answer:
Thanks for asking on HealthcareMagic.
CRP or C-Reactive protein and ESR or Erythrocyte sedimentation rate are two parameters which indicate that there is some infective or inflammatory reaction going on in the body. The leucocytes of white blood cells, in particular the neutrophils, act as the policing system of the body. It would have been better if you had mentioned the exact count but a rise in leucocyte count indicates an infection.
In summary, your child is likely to be suffering from a bacterial infection and requires to be treated with antibiotics. Whether oral antibiotics would be fine or intravenous antibiotics need to be administered (after getting the child admitted), is a decision that I am not in a position to make since I cannot assess the child clinically. I think accepting your doctor's judgement would be a better idea in this regard.
Since the fever is lasting for 10 days or more, I would also insist on getting certain blood tests done to rule out typhoid fever. Please talk to your doctor about the same.
Hope that helps.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Haemoglobin = 13.9%
Leucocytes = 9,500/mm (3)
Lecocytes, Differential Neutrophils = 61%
Lympocytes = 30%
ESR = 44 mm/hr
Platelet = 3.0 Lakhs/mm (3)
The doctor I visited is asking us to get Chest X-ray, Malarial tests etc. DO these needed
-- Can you please suggest a good doctor in ShivajiNagar /Cunningham Road, XXXXXXX area?
-- What other tests are needed
please help suggest.
Leucocytes = 9,500/mm (3)
Lecocytes, Differential Neutrophils = 61%
Lympocytes = 30%
ESR = 44 mm/hr
Platelet = 3.0 Lakhs/mm (3)
The doctor I visited is asking us to get Chest X-ray, Malarial tests etc. DO these needed
-- Can you please suggest a good doctor in ShivajiNagar /Cunningham Road, XXXXXXX area?
-- What other tests are needed
please help suggest.
Brief Answer:
I would like to test for typhoid and urinary tract infection
Detailed Answer:
Thanks for writing back.
I have gone carefully through the details. Since the leucocyte count is not high, there is less likelihood of a bacterial infection. A quantitative assessment of CRP would have helped more. If the CRP is slightly raised, I would not worry much but a higher CRP warrants treatment with antibiotics. I would prefer giving antibiotics in such a case as that of your child.
The requirement of tests depends on the associated symptoms. Since, the cause has not yet been identified, your doctor is trying to find the focus of infection by getting the Chest X Ray or Malaria test. But I would have suggested some other tests instead. As mentioned in the last answer, I would try to exclude typhoid by getting a Widal test or a Typhidot IgM test done. I would also try to exclude urinary tract infection by getting a routine microscopy of urine done. If either of these tests turn out negative yet the fever continues I would go for the other tests mentioned. I would not suggest Chest X Ray unless there is cough associated.
I am sorry that I am unaware of good doctors in your area in XXXXXXX but looking up the following link should help:
https://www.practo.com/bangalore/pediatrician
Hope that helps.
Regards
Dr. Diptanshu Das
I would like to test for typhoid and urinary tract infection
Detailed Answer:
Thanks for writing back.
I have gone carefully through the details. Since the leucocyte count is not high, there is less likelihood of a bacterial infection. A quantitative assessment of CRP would have helped more. If the CRP is slightly raised, I would not worry much but a higher CRP warrants treatment with antibiotics. I would prefer giving antibiotics in such a case as that of your child.
The requirement of tests depends on the associated symptoms. Since, the cause has not yet been identified, your doctor is trying to find the focus of infection by getting the Chest X Ray or Malaria test. But I would have suggested some other tests instead. As mentioned in the last answer, I would try to exclude typhoid by getting a Widal test or a Typhidot IgM test done. I would also try to exclude urinary tract infection by getting a routine microscopy of urine done. If either of these tests turn out negative yet the fever continues I would go for the other tests mentioned. I would not suggest Chest X Ray unless there is cough associated.
I am sorry that I am unaware of good doctors in your area in XXXXXXX but looking up the following link should help:
https://www.practo.com/bangalore/pediatrician
Hope that helps.
Regards
Dr. Diptanshu Das
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi
I visited doctor and he insisted me to get Malarial tests done. On top of that, he prescribed one another test for TB. For that the Lab guy gave an injection to my son and instructed us not to touch that part or not to have bath to my son.
What is that injection.
He is also insisting to get chest X-Ray done to clear of TB doubts, which we are resisting.
How come he is suspecting TB when my child isnt have any signs of COUGH.
My son though has nose congestion.
Please suggest about that Injection & is it really X-Ray needed. Why is that you think the doctor is suspecting TB
I visited doctor and he insisted me to get Malarial tests done. On top of that, he prescribed one another test for TB. For that the Lab guy gave an injection to my son and instructed us not to touch that part or not to have bath to my son.
What is that injection.
He is also insisting to get chest X-Ray done to clear of TB doubts, which we are resisting.
How come he is suspecting TB when my child isnt have any signs of COUGH.
My son though has nose congestion.
Please suggest about that Injection & is it really X-Ray needed. Why is that you think the doctor is suspecting TB
Brief Answer:
No harm getting Chest X ray done. But other tests more important.
Detailed Answer:
Thanks for writing back.
The first thing that I would like to ask is whether tests for typhoid have been done. The second would be to look into the urine for infection. These are way more probable than tuberculosis. Your doctor perhaps suspects tuberculosis since the child has prolonged fever. But in case of tuberculosis, the lymphocyte count should have gone up. That does not seem to be the case. The injection that has been put, is called Mantoux test, which could give an indication whether the child could be suffering from tuberculosis. From my side, I was not even insisting on getting an X ray done if there is no cough or respiratory symptom. I have doubts whether your doctor is proceeding in the right direction. I would insist you to get a second opinion. I have already suggested the tests in the earlier answers. Getting them done before you visit some other doctor, should help.
Regards
Dr. Diptanshu Das
No harm getting Chest X ray done. But other tests more important.
Detailed Answer:
Thanks for writing back.
The first thing that I would like to ask is whether tests for typhoid have been done. The second would be to look into the urine for infection. These are way more probable than tuberculosis. Your doctor perhaps suspects tuberculosis since the child has prolonged fever. But in case of tuberculosis, the lymphocyte count should have gone up. That does not seem to be the case. The injection that has been put, is called Mantoux test, which could give an indication whether the child could be suffering from tuberculosis. From my side, I was not even insisting on getting an X ray done if there is no cough or respiratory symptom. I have doubts whether your doctor is proceeding in the right direction. I would insist you to get a second opinion. I have already suggested the tests in the earlier answers. Getting them done before you visit some other doctor, should help.
Regards
Dr. Diptanshu Das
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for ALL the guidance. It really helped a lot.
Urine & Widal tests hasnt shown any signs of Issues. Those were clear.
The Montoux test also isnt showing any signs of rashes/redness at the injection point till now. Though i think it needs another day to get confirm.
When we told doctor about the Nose congestion, he carefully checked that part and pointed that the fever is because of NOSE infection. Infection of Little area of Nose.
Prescribed the Antibiotic - MoxClav 457mg and an ointment Fucidin to apply at little area of Nose.
Urine & Widal tests hasnt shown any signs of Issues. Those were clear.
The Montoux test also isnt showing any signs of rashes/redness at the injection point till now. Though i think it needs another day to get confirm.
When we told doctor about the Nose congestion, he carefully checked that part and pointed that the fever is because of NOSE infection. Infection of Little area of Nose.
Prescribed the Antibiotic - MoxClav 457mg and an ointment Fucidin to apply at little area of Nose.
Brief Answer:
Complete full course of the prescribed antibiotic
Detailed Answer:
Glad that you found my answers to be helpful.
Since a focus of infection has already been identified, chances are that treating it will resolve the fever. I did not expect much information from Mantoux test but it is ok that your doctor wanted to be sure.
I hope that with the medicines your child would soon be fine.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
Complete full course of the prescribed antibiotic
Detailed Answer:
Glad that you found my answers to be helpful.
Since a focus of infection has already been identified, chances are that treating it will resolve the fever. I did not expect much information from Mantoux test but it is ok that your doctor wanted to be sure.
I hope that with the medicines your child would soon be fine.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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