Bandemia: Difference between revisions
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*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, CXR if respiratory symptoms | **Blood cultures, CBC, CMP, UA, viral swabs, CXR if respiratory symptoms | ||
**Complete physical | **Complete physical exam | ||
===Diagnosis=== | ===Diagnosis=== | ||
Revision as of 09:22, 11 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 w/ diff
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