Complete Blood Cell Count- CBC

Hint for Pathological Symptoms

NTTH-HCMIU-IM-2014

COMPLETE BLOOD COUNT WITH DIFFERENTIAL

(CBC WITH DIFF)
References Ranges
Erythrocytes (RBC)

4.0 to 5.4

M/uL

Thrombocytes (Platelets)

145 to 400

K/uL

Leukocytes (WBC)

4.8 to 10.8

K/uL

40 to 74

Neutrophils
Band neutrophils

0 to 9

Eosinophils

0 to 6

Basophils

0 to 1

Lymphocytes
Monocytes

15 to 47
0 to 12

NTTH-HCMIU-IM-2014

CASE STUDY-I
47 year old female presents to ER with 24- hour history
Fever (101.3 F/ 38.5 C)
Rigors (shaking chills)
Headache
Chest pain
Cough
Shortness of breath
Admitting diagnosis (?)
Diagnostic studies
Radiology and laboratory

NTTH-HCMIU-IM-2014

CASE STUDY-I
Laboratory studies
Blood
CBC with differential
Basic metabolic panel (BMP)
C-reactive protein (CRP)
Culture

Sputum
Culture

Radiology studies

NTTH-HCMIU-IM-2014

CASE STUDY-I
Laboratory studies
CBC with diff

WBC
Neutrophils
Bands
Monocytes
Lymphocytes

P
40.7 K/uL
44
%
46
%
1
%
8
%

RR
4.8 to 10.8
40 to 74
0 to 9
0 to 12
15 to 47

BMP

mild elevation of BUN and creatinine

CRP

24 mg/dL

> 1.0 mg/dL

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CASE STUDY- I
Sputum
Gram stained smear
50 WBCs per high power field
Numerous gram-positive cocci in pairs and short chains

Culture
Heavy Streptococcus pneumoniae

Blood cultures
Gram stained smear
Gram-positive cocci in pairs and short chains

Culture
Streptococcus pneumoniae

NTTH-HCMIU-IM-2014

CASE STUDY II
22 year old male presents to ED with 36- hour history of
Fever (100.4 F/ 38 C)
Headache
Nausea
Vomiting
AMS (Irritability)
Anorexia
Nuchal rigidity
Photophobia
Admitting and differential diagnosis (?)

NTTH-HCMIU-IM-2014

CASE STUDY II
Diagnostic studies
Radiology
Laboratory
Blood
CBC with diff, BMP and CRP
Cerebrospinal fluid (CSF)
Glucose, protein and cells (number and type)
Culture
Polymerase chain reaction (PCR)
NTTH-HCMIU-IM-2014

CASE STUDY- II
Laboratory studies

Cerebrospinal fluid (CSF)

Range
Cell #
Cell type

Patient
465 / uL

Reference
0 - 8 / uL

Lymphocytes (97%)

Protein

117 mg/dL

15 45 mg/dL

Glucose

43 mg/dL

40 70 mg/dL
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NTTH-HCMIU-IM-2014

CASE STUDY III

50 year old female presents to ER with 15 to18 hour
history
Fever (103.1 F)
Headache
AMS (Irritability and confusion)
Nausea
Vomiting
Nuchal rigidity
Sore throat
Photophobia

Admitting and differential diagnosis (?)

NTTH-HCMIU-IM-2014

CASE STUDY III

Diagnostic studies
Radiology
Laboratory
Blood
CBC with diff, BMP and CRP
Cerebrospinal fluid
Protein, glucose and cells (number and type)
Culture
Bacterial antigens (latex agglutination)

NTTH-HCMIU-IM-2014

CASE STUDY -III

Blood
CBC with diff
Leukocytes
Neutrophils

BMP
CRP

30.2
88

4.8-10.8 K/uL
40-74 %

(normal)
12 mg/dL

>1 mg/dL

Cerebrospinal fluid
Gram stain
50 WBCs per high power field
Numerous gram-positive cocci in pairs and chains

Culture
Heavy Streptococcus pneumoniae

NTTH-HCMIU-IM-2014

CASE STUDY III

Laboratory diagnosis

Cerebrospinal Fluid (CSF)

Range
Cell #
Cell type

Patient
2,100 / uL

Reference
0 8 uL

Neutrophils (98%)

Protein

325 mg/dL

15 45 mg/dL

Glucose
mg/dL

10 mg/dL

40 70
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