Band neutrophil counts are unnecessary for the diagnosis of infection in patients with normal total leukocyte counts

Abstract

The authors have assessed the clinical value of an "accurate" band count as a correlate to infection in 33 patients with a culture proven bacterial infection and a normal total leukocyte count. Thirty hematologically normal outpatients, presumably with no infections, were selected for the control group. Manual 500 cell differentials were performed on each subject in both groups. The absolute and percent band count, the absolute and percent total neutrophil count, and the presence of neutrophils more immature than bands were analyzed for their ability to identify the patients with an infection. The presence of neutrophils more immature than bands and the absolute neutrophil count are the two values that best separated the infected patients from the outpatients, even though the selected patients had a normal total leukocyte count. The band count had minimal value for identifying infected patients. Other studies were reviewed regarding the utility of band counts. The authors conclude that manual band counts are unnecessary because when accompanied by a clinical assessment of the patient, automated instruments accurately provide the appropriate hematologic data that may aid in the diagnosis of infection.