[dr.Ira]

Normal White Blood Cell Count Does Not Rule Out BacteremiaDaniel J. Pallin, MD, MPH






Of 289 patients with bacteremia, 52% had normal WBC count and 17% had neither WBC elevation nor fever.

Despite multiple studies showing that a normal white blood cell (WBC) count does not exclude serious disease, physicians in all specialties continue to behave as if it did. To assess whether a normal WBC count or absence of fever reliably excludes bacteremia in patients with suspected infection, investigators conducted a secondary analysis of data from a prospective study of 3563 adults who had blood cultures at a single emergency department.

Among 289 patients (8%) with positive blood cultures, 77% had fever and 48% had elevated WBC count on initial measurement. Neither fever nor an elevated WBC count was noted in 17% of bacteremic patients.

Posted: 07/03/2012; Journal Watch © 2012 Massachusetts Medical Society

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