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  • Perinatal/Neonatal Case Presentation
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Perinatal/Neonatal Case Presentation

White blood cell left shift in a neonate: a case of mistaken identity

Journal of Perinatology volume 26, pages 378–380 (2006)Cite this article

Abstract

We present a full-term male infant who presented with tachypnea and an increased band count on his complete blood count (CBC) with an immature to total neutrophil (I:T) ratio of 0.6 raising suspicion of early onset sepsis. A blood culture was drawn and he was started on appropriate antibiotics. The patient's clinical condition rapidly improved; however, the white cell count ‘left shift’ persisted. When a detailed family history was obtained, it was discovered that the father, paternal uncle and the grandfather had been diagnosed with Pelger-Huet anomaly (PHA). As the urine, blood and CSF cultures were all negative in this now well-appearing infant, the left shift on the CBC was believed to be due to inheritance of the PHA. We present this case to emphasize that even in this age of sophisticated laboratory evaluation, a good clinical history, including family history, and clinical evaluation, are essential for accurate diagnosis.

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Acknowledgements

We specially thank NNPs Deborah Maxwell, Nancy Barclay, Sharon Koch, Jacqueline Deschamps for the expert clinical care of this infant.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, NY, USA

    I S I Mohamed, R J Wynn, K Cominsky, A M Reynolds, R M Ryan, V H Kumar & S Lakshminrusimha

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  1. I S I Mohamed
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  2. R J Wynn
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  3. K Cominsky
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  4. A M Reynolds
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  5. R M Ryan
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  6. V H Kumar
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  7. S Lakshminrusimha
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Correspondence to S Lakshminrusimha.

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Mohamed, I., Wynn, R., Cominsky, K. et al. White blood cell left shift in a neonate: a case of mistaken identity. J Perinatol 26, 378–380 (2006). https://doi.org/10.1038/sj.jp.7211513

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  • DOI: https://doi.org/10.1038/sj.jp.7211513

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