Bandemia: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*There are no clinical features specific to bandemia | *There are no clinical features specific to bandemia | ||
*Generally defined as > 6% band cells on a CBC | *Generally defined as >6% band cells on a CBC with differential | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 15: | Line 15: | ||
*Complete history and physical | *Complete history and physical | ||
**Look for any source of infection | **Look for any source of infection | ||
** | ***Consider decubitus ulcers | ||
**Consider GU | ***Consider GU sources in women and young uncircumcised boys | ||
**Consider pulmonary source | ***Consider pulmonary source | ||
**Consider GI source | ***Consider GI source including gallbladder | ||
===Workup=== | ===Workup=== | ||
*Blood cultures, CBC, CMP, UA, viral swabs, CXR if respiratory symptoms | |||
*Complete physical exam | |||
===Diagnosis=== | ===Diagnosis=== | ||
Latest revision as of 21:48, 17 July 2024
Background
- Bandemia (also referred to as a "left shift") refers to an excess of immature neutrophil precursor cells (band cells)
- The origin of the phrase "left shift," is commonly thought to stem from the left-most button arrangement of early cell sorting machines
- A left shift refers SPECIFICALLY to increase bands and not increased neutrophils, which can increase in the setting of seizure, MI, pain or any stress response.
Clinical Features
- There are no clinical features specific to bandemia
- Generally defined as >6% band cells on a CBC with differential
Differential Diagnosis
- Bandemia typically indicates a serious underlying inflammatory or infectious process
Evaluation
- Complete history and physical
- Look for any source of infection
- Consider decubitus ulcers
- Consider GU sources in women and young uncircumcised boys
- Consider pulmonary source
- Consider GI source including gallbladder
- Look for any source of infection
Workup
- Blood cultures, CBC, CMP, UA, viral swabs, CXR if respiratory symptoms
- Complete physical exam