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# WBC Count and Differential White blood cell (leukocyte) count is used as an indicator of bacterial and viral infection. WBC is reported as the total number of all white blood cells: | Age | WBC Count (mm³) | |---|---| | Neonate | 9000-30,000 | | 1 month | 5000-19,500 | | 1-3 years | 6000 - 17,500...

# WBC Count and Differential White blood cell (leukocyte) count is used as an indicator of bacterial and viral infection. WBC is reported as the total number of all white blood cells: | Age | WBC Count (mm³) | |---|---| | Neonate | 9000-30,000 | | 1 month | 5000-19,500 | | 1-3 years | 6000 - 17,500 | | 8-13 years | 4500-13,500 | | > 18 years | 4500-11,000 | The *differential* provides the percentage of each different type of leukocyte. An increase in the white blood cell count is usually related to an increase in one type and often an increase in immature neutrophils, known as *bands*, referred to as a "shift to the left", an indication of an infectious process: | Cell | Normal Value | Changes | |---|---|---| | Immature neutrophils (bands) | 1-3% | Increase with infection | | Segmented neutrophils (segs) | 50-62% | Increase with acute, localized, or systemic bacterial infections | | Eosinophils | 0-3% | Decrease with stress and acute infection | | Basophils | 0-1% | Decrease during acute stage of infection | | Lymphocytes | 25-40% | Increase in some viral and bacterial infections | | Monocytes | 3-7% | Increase during recovery stage of acute infection | # Sickle Cell Disease Sickle cell disease is a recessive genetic disorder of chromosome 11, causing hemoglobin to be defective so that red blood cells (RBCs) are sickle-shaped and inflexible, resulting in their accumulating in small vessels and causing painful blockage. While normal RBCs survive 120 days, sickled cells may survive only 10-20 days, stressing the bone marrow that can't produce fast enough and resulting in severe anemia. Different types of crises (aplastic, hemolytic, vaso-occlusive, and sequestrating) occur, which can cause infarctions in organs, severe pain, damage to organs, and rapid enlargement of liver and spleen. Factors that precipitate crises include fever, dehydration, high or low altitude, temperature extremes, vomiting, stress, fatigue, consumption of alcohol, pregnancy, exertion, acidosis, and increased hemoglobin and/or reticulocyte counts. Complications include anemia, acute chest syndrome, congestive heart failure, strokes, delayed growth, infections, pulmonary hypertension, liver and kidney disorders, retinopathy, seizures, and osteonecrosis.