ASPHO April 2015 Case Quiz

Infant with Neutropenia
Julie Bennett, MD, Fellow, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
Angela Punnett, MD, Staff, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
 

A 1-month-old male presented to the emergency department with fever for several hours. He had been previously healthy. His birth history was unremarkable, and there were no complications with the pregnancy or delivery. The family is of South-Asian descent, and the parents were nonconsanguineous. On examination, the infant looked well. His vital signs were temperature 38.4, heart rate 168, blood pressure 85/50, respiratory rate 35, O₂ sats 100% on room air. No focus of infection was found.

A full septic workup was done, revealing the following complete blood count (CBC):

WBC                            10.5 x 10⁹/L
Hgb                              108 g/L
Plt                                583 x 10⁹/L
Neutrophils                  0.11 x 10⁹/L
Lymphocytes                5.87 x 10⁹/L
Monocytes                    2.73 x 10⁹/L
Eosinophils                   1.68 x 10⁹/L