Conditions Associated with Leukocytosis in a Tertiary Care Hospital, with Particular Attention to the Role of Infection Caused by Clostridium difficile
Few modern studies have enumerated the conditions associated with leukocytosis. Our clinical experience has implicated Clostridium difficile infection in a substantial proportion of patients with leukocytosis. In a prospective, observational study of 400 inpatients with WBC counts of ⩾15,000 cells/m...
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| Veröffentlicht in: | Clinical infectious diseases 2002-06, Vol.34 (12), p.1585-1592 |
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| creator | Wanahita, Anna Goldsmith, Elizabeth A. Musher, Daniel M. |
| description | Few modern studies have enumerated the conditions associated with leukocytosis. Our clinical experience has implicated Clostridium difficile infection in a substantial proportion of patients with leukocytosis. In a prospective, observational study of 400 inpatients with WBC counts of ⩾15,000 cells/mm3, we documented ⩾1 infection in 207 patients (53%). Of these 207 patients, 97 (47%) had pneumonia, 60 (29%) had urinary tract infection, 34 (16%) had soft-tissue infection, and 34 (16%) had C. difficile infection. C. difficile infection was present in 25% of patients with WBC counts of µ30,000 cells/mm3 who did not have hematological malignancy. Other causes of leukocytosis in the 400 patients included physiological stress, in 152 patients (38%); medications or drugs, in 42 (11%); hematological disease, in 22 (6%); and necrosis or inflammation, in 22 (6%). C. difficile infection is a prominent cause of leukocytosis and this diagnosis should be considered for patients with WBC counts of ⩾15,000 cells/mm3, even in the absence of diarrheal symptoms. |
| doi_str_mv | 10.1086/340536 |
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Our clinical experience has implicated Clostridium difficile infection in a substantial proportion of patients with leukocytosis. In a prospective, observational study of 400 inpatients with WBC counts of ⩾15,000 cells/mm3, we documented ⩾1 infection in 207 patients (53%). Of these 207 patients, 97 (47%) had pneumonia, 60 (29%) had urinary tract infection, 34 (16%) had soft-tissue infection, and 34 (16%) had C. difficile infection. C. difficile infection was present in 25% of patients with WBC counts of µ30,000 cells/mm3 who did not have hematological malignancy. Other causes of leukocytosis in the 400 patients included physiological stress, in 152 patients (38%); medications or drugs, in 42 (11%); hematological disease, in 22 (6%); and necrosis or inflammation, in 22 (6%). 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Our clinical experience has implicated Clostridium difficile infection in a substantial proportion of patients with leukocytosis. In a prospective, observational study of 400 inpatients with WBC counts of ⩾15,000 cells/mm3, we documented ⩾1 infection in 207 patients (53%). Of these 207 patients, 97 (47%) had pneumonia, 60 (29%) had urinary tract infection, 34 (16%) had soft-tissue infection, and 34 (16%) had C. difficile infection. C. difficile infection was present in 25% of patients with WBC counts of µ30,000 cells/mm3 who did not have hematological malignancy. Other causes of leukocytosis in the 400 patients included physiological stress, in 152 patients (38%); medications or drugs, in 42 (11%); hematological disease, in 22 (6%); and necrosis or inflammation, in 22 (6%). C. difficile infection is a prominent cause of leukocytosis and this diagnosis should be considered for patients with WBC counts of ⩾15,000 cells/mm3, even in the absence of diarrheal symptoms.</description><subject>Adult</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Biological and medical sciences</subject><subject>Clostridium difficile</subject><subject>Colitis</subject><subject>Diarrhea</subject><subject>Enterocolitis, Pseudomembranous - complications</subject><subject>Enterocolitis, Pseudomembranous - microbiology</subject><subject>Hospitalization</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Inflammation</subject><subject>Leukocyte Count</subject><subject>Leukocytosis</subject><subject>Leukocytosis - complications</subject><subject>Leukocytosis - microbiology</subject><subject>Major Articles</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medications</subject><subject>Necrosis</subject><subject>Outpatients</subject><subject>Physiological stress</subject><subject>Prospective Studies</subject><subject>Stress, Physiological - etiology</subject><subject>Toxins</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFktFqFDEUhoMotlZ9ApF4oVeOJpNkkrlcBtstLCpSoXgTMpmEpp2drDkZtE_i6zZ1lu6VeJXA9_Efcv4g9JKSD5So5iPjRLDmETqmgsmqES19XO5EqIorpo7QM4BrQihVRDxFR7QmrFYtO0Z_ujgNIYc4AV4BRBtMdgP-FfIV3rj5JtrbHCEADhM2-MKlHEy6xZ1JDq8j7EI24_tF_2oKtPNoEl7l7Kb7UJwjzlcOf4ujw9Hj88k7-xd0ZoYyqC9ZY4ScwhDmLR6C98GG0T1HT7wZwb3Ynyfo--mni25dbb6cnXerTWV5TXPVM1EPxhJhiGFKNFRSx3zPpBvK25X0rRlETb3ixjbS8X6wrVB9K8oCesUFO0Hvltxdij9nB1lvA1g3jmZycQYtS6JSgv1XpIo3tRT1QbQpAiTn9S6FbVmapkTfd6WXror4ep8491s3HLR9OUV4uxcMWDP6ZCYb4OAxKRlrSfHeLF6cd_8e9mpxriHH9GDx8jtoIwuuFhwgu98P2KQbXagUen35Q59-5lxIcqkJuwOcVr7Q</recordid><startdate>20020615</startdate><enddate>20020615</enddate><creator>Wanahita, Anna</creator><creator>Goldsmith, Elizabeth A.</creator><creator>Musher, Daniel M.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20020615</creationdate><title>Conditions Associated with Leukocytosis in a Tertiary Care Hospital, with Particular Attention to the Role of Infection Caused by Clostridium difficile</title><author>Wanahita, Anna ; Goldsmith, Elizabeth A. ; Musher, Daniel M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-b352dac05a0a3856171e3fb37ed05887f9ad521f84ac67e4bdc958b95203b8453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the digestive system and abdomen</topic><topic>Biological and medical sciences</topic><topic>Clostridium difficile</topic><topic>Colitis</topic><topic>Diarrhea</topic><topic>Enterocolitis, Pseudomembranous - complications</topic><topic>Enterocolitis, Pseudomembranous - microbiology</topic><topic>Hospitalization</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Inflammation</topic><topic>Leukocyte Count</topic><topic>Leukocytosis</topic><topic>Leukocytosis - complications</topic><topic>Leukocytosis - microbiology</topic><topic>Major Articles</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medications</topic><topic>Necrosis</topic><topic>Outpatients</topic><topic>Physiological stress</topic><topic>Prospective Studies</topic><topic>Stress, Physiological - etiology</topic><topic>Toxins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wanahita, Anna</creatorcontrib><creatorcontrib>Goldsmith, Elizabeth A.</creatorcontrib><creatorcontrib>Musher, Daniel M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wanahita, Anna</au><au>Goldsmith, Elizabeth A.</au><au>Musher, Daniel M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Conditions Associated with Leukocytosis in a Tertiary Care Hospital, with Particular Attention to the Role of Infection Caused by Clostridium difficile</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2002-06-15</date><risdate>2002</risdate><volume>34</volume><issue>12</issue><spage>1585</spage><epage>1592</epage><pages>1585-1592</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Few modern studies have enumerated the conditions associated with leukocytosis. Our clinical experience has implicated Clostridium difficile infection in a substantial proportion of patients with leukocytosis. In a prospective, observational study of 400 inpatients with WBC counts of ⩾15,000 cells/mm3, we documented ⩾1 infection in 207 patients (53%). Of these 207 patients, 97 (47%) had pneumonia, 60 (29%) had urinary tract infection, 34 (16%) had soft-tissue infection, and 34 (16%) had C. difficile infection. C. difficile infection was present in 25% of patients with WBC counts of µ30,000 cells/mm3 who did not have hematological malignancy. Other causes of leukocytosis in the 400 patients included physiological stress, in 152 patients (38%); medications or drugs, in 42 (11%); hematological disease, in 22 (6%); and necrosis or inflammation, in 22 (6%). C. difficile infection is a prominent cause of leukocytosis and this diagnosis should be considered for patients with WBC counts of ⩾15,000 cells/mm3, even in the absence of diarrheal symptoms.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>12032893</pmid><doi>10.1086/340536</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Clostridium difficile Colitis Diarrhea Enterocolitis, Pseudomembranous - complications Enterocolitis, Pseudomembranous - microbiology Hospitalization Human bacterial diseases Humans Infections Infectious diseases Inflammation Leukocyte Count Leukocytosis Leukocytosis - complications Leukocytosis - microbiology Major Articles Male Medical sciences Medications Necrosis Outpatients Physiological stress Prospective Studies Stress, Physiological - etiology Toxins |
| title | Conditions Associated with Leukocytosis in a Tertiary Care Hospital, with Particular Attention to the Role of Infection Caused by Clostridium difficile |
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