Abnormal Blood Test Results in Pediatric Infections - Pediatrics

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When interpreting abnormal blood test results in pediatric patients, especially in the context of infections, it is crucial to understand the implications of the various components of the complete blood count (CBC) and other relevant markers. In your daughter's case, the blood test results show an elevated white blood cell count (WBC) of 16.8 (normal range: 3.5-11), a significantly high percentage of segmented neutrophils (91.2%, normal range: 42-74), and a low lymphocyte count (6.5%, normal range: 20-56). Additionally, the C-reactive protein (CRP) level is elevated at 8.7 (normal <5), indicating inflammation.

1. Infections Leading to Increased WBC and Decreased Lymphocytes: The combination of high WBC, particularly with a predominance of neutrophils, and low lymphocytes often suggests a bacterial infection. Common infections that can lead to this pattern include bacterial pneumonia, urinary tract infections, or other localized infections where neutrophils are mobilized to fight off the bacteria. Viral infections, on the other hand, typically present with a higher lymphocyte count. In your daughter's case, the recent influenza infection may have complicated her immune response, leading to a secondary bacterial infection, which is not uncommon after viral illnesses.
2. Persistent Fever and Management: Given that your daughter continues to have a fever despite medication, it is essential to monitor her closely. A fever that persists after treatment can indicate that the underlying infection has not been adequately addressed or that a new infection has developed. If her fever remains high (above 38°C) and she exhibits other concerning symptoms such as difficulty breathing, lethargy, or dehydration, it would be prudent to seek further medical evaluation.
In terms of management, the medications prescribed (Amoxicillin, Ibuprofen, Dextromethorphan, and a rectal suppository for fever) are appropriate for treating bacterial infections and managing symptoms. However, if her condition does not improve within 48 hours, or if she worsens, it would be advisable to return to the healthcare provider for further evaluation. This may include additional blood tests, imaging studies (like a chest X-ray), or even hospitalization if her clinical status deteriorates.

In summary, the abnormal blood test results suggest a likely bacterial infection, possibly secondary to her recent influenza. Continuous monitoring of her symptoms and response to treatment is crucial. If her fever persists or worsens, do not hesitate to seek immediate medical attention. It is always better to err on the side of caution, especially in pediatric patients.