eMedicine Specialties > Hematology > Immune System and Disorders
Neutropenia: Differential Diagnoses & Workup
Updated: Oct 4, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Acquired immunodeficiency syndrome (AIDS)
Chronic myelomonocytic leukemia
Workup
Laboratory Studies
- CBC count with manual differential is indicated.
- In patients with neutropenic fever, the following tests should be obtained, although their yield is low:
- Two sets of blood cultures
- Urinalysis and urine culture
- Sputum Gram stain and culture
- Obtain serum vitamin B-12 and RBC folate levels.
- Perform HIV testing if clinical risk factors are present.
Imaging Studies
- If the neutropenic patient is febrile, obtain a posterior-anterior and lateral chest radiograph to assess for signs of pneumonia.
Procedures
- If anemia and thrombocytopenia are present, performing a bone marrow aspiration and biopsy is indicated.
- Obtaining a bone marrow biopsy to assess for an intrinsic marrow defect, maturation arrest, congenital neutropenia, fungal infection, and a vitamin B-12 or folate deficiency.
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Differential Diagnoses & Workup: Neutropenia |
| Treatment & Medication: Neutropenia |
| Follow-up: Neutropenia |
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References
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Further Reading
Related eMedicine Topics
- Agranulocytosis
- Autoimmune and Chronic Benign Neutropenia [in the Pediatrics: General Medicine section]
- Granulocytopenia
- Kostmann Disease [in the Pediatrics: General Medicine section]
- Fatigue and Symptom Burden in Febrile Neutropenia
- Safety and Effectiveness of Granulocyte Transfusions in Resolving Infection in People With Neutropenia (The RING Study)
- ACR Appropriateness Criteria® fever without source - child. American College of Radiology - Medical Specialty Society. 1999 (revised 2008). 8 pages. NGC:007009
- 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. American Society of Clinical Oncology - Medical Specialty Society. 1994 Nov (revised 2006 Jul 1). 19 pages. NGC:005040
Keywords
neutropenia, Schultz disease, agranulocytosis, granulocytopenia, leukopenia, neutropenic fever, circulating neutrophils, granulocyte colony-stimulating factor, G-CSF, bone marrow transplantation, Kostmann syndrome, Shwachman-Diamond syndrome, Zinsser-Cole-Engman syndrome
Differential Diagnoses & Workup: Neutropenia