Pharyngitis

Hello,

My doctor diagnosed me a sevee pharyngitis with "white fluid" in my throat.
Fever.aches.severe sore throat-one little node under the jaw and one little one under my arm- both a little bit painful
MNI test negative
CBC reports : Hyper leukocytosis with
hyperneutrophilia high count above the norm 9000 (lab value max range 7000)
Lymphopenia with a low count under the norm- 600 ( lab value min range 1000- my previous was at 2000)
So I was prescribed 10 days of antibiotics (amoxicillin and clavulanic acid)
In 48/72 hours the main symptoms disappeared. I finished my treatment of ten 10 days and I m Ok except a little anal mycosis (antibiotics?)

I am concerned with my CBC. Is it normal ? Bacterial infection ? I can read many terrible things on the net ?

Please help me to understand. May be my ORL think it is not necessary to explain me.

Thanks in advance

[Joseph Sclafani, M.D.]

Hello,

Thank you for your question.

Generally if one of my patients complained of the same symptoms you described in your question, I would be suspicious of a bacterial pharyngitis caused by a Group A Streptococcal (“Strep throat”).

In adults, there are specific criteria, called the Centor criteria:
- Fever: subjective or measured >100.5°F
- Absence of cough
- Tender anterior cervical lymphadenopathy (swollen lymph node in neck)
- Tonsillar exudates (white fluid)

It seems you have at least 3 of these (you didn’t mention that you didn’t have a cough). In general, I treat patients with antibiotics with 4 of these criteria.In patients with 2,3, criteria I perform a rapid strep test before I make the diagnosis.

To answer your question and hopefully relieve some of your anxiety, it is very common for patients to have a leukocytosis with a predominance of neutrophils like you describe in your question. It should not cause you excessive worry. I am glad that you responded so well with resolution of your symptoms within 48 to 72 hours.

Thank you,
Dr. S

[Jnab]

Thank you doctor.
To conclude what about such a low count of lymphocytes. Is it common in those types of infections ?
That is my last concern.
Hope to read you soon.

Thanks in advance.