meghana jadhav
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The diagnosis of septicemia should be considered in patients who are at increased risk of blood stream infection (often secondary to local disease, such as urinary tract infection or pneumonia). All of the following are factors predisposing patients to septicemia except:
A. Underlying diseases that appear to compromise host defenses, such as diabetes, lymphoma, etc.
B. Patients with a polymorphonuclear leukocyte count less than 1000/mm3
C. Patients with polymorphonuclear leukocyte counts of 10,000 to 20,000
D. Long term therapy with broad-spectrum antimicrobials.
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megha
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| meghana jadhav
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...no body to ans....
i will give ans....but i am not convineced with the ans ...given...thats
C. Patients with polymorphonuclear leukocyte counts of 10,000 to 20,000 .....
can anybody explain????
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megha
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| mani
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i saw the question but none of the options seemed appealing. i too have doubts about this as pts with leukemia are also immune compromised due to multiple factors. but this high count could be due to some infection, in which case this option might sound good. i havent seen counts above 15000-17000/cmm clinicaly in any sort of inf
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| Malaysian
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Hi....I believe A and B are self explanatory so I wont dwelve on that.When I read the question my answer matched C. as what meghana said.
D. can't be the answer because blood is sterile anyway.....so by giving long term antibioitics its not going to change anything it may change the flora in the gut or skin and cause oppotunistic infection but its not going to change the 'sterility' of the blood.
The WBC count of 10,000-20,000 does not mean its leukaemia.Leukaemia usually have levels higher than this......a normal person's WBC cut off point is 11,000 and when he/she is infected it can go up to the 10,000-20,000 level and so is protective rather than detrimental.
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| meghana jadhav
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thax 4 ur answer. malaysian......now i got the point....
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megha
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| bactitech
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It is not quite true that leukemia necessarily has a high white count. The ABSOLUTE count of each type of white cell can be the deciding factor.
In 1985 my mother-in-law (now deceased) had "routine" blood work done. Her total WBC count hovered around 9-10,000, but her absolute lymphocytes were notably elevated. The tech who read her diff saw smudge cells on the differential and had a pathologist review the slide. They came up with a diagnosis of "possible early CLL (chronic lymphocytic leukemia." A subsequent CBC a week later showed the same results. A bone marrow about a month later confirmed the diagnosis. There are many types of leukemia.
As far as the question at hand, none of the answers are really good. From my tech experience, I would pick (C). A,B, and D are a typical predisposing condition for patients to present with odd-ball organisms or yeasts in their blood. With C you can have septicemia also depending on the organism, location of the primary infection (urine, respiratory tract). It also depends upon how you define "septicemia." There has been discussion lately in tech journals about transient septicemia, i.e. one blood culture with Staph. aureus and 2 other negatives, or Coag neg staph in a patient with an indwelling catheter presenting with one positive. Is this septicemia or contamination or colonization of the cath tip? This is not a cut and dried topic, by any means - ask any ID doc.
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