Neutrophil Disorders

Dysfunction of neutrophils or paucity of neutrophils compromises host defenses.  Organisms present on the skin surface or in the gut cause infections.  The most common are skin (cellulitis), pulmonary infections (pneumonia, sinusitis), and G.I. tract (stomatitis, gingivitis, perirectal abcess).  Infections in unusual areas such as liver or brain abcesses, or involving uncommon organisms such as Aspergillus pneumonia, Serratia marescens, Nocardia, Pseudomonas cepacia should also raise the suspicion of phagocyte inadequacy.

Qualitative Disorders

Quantitative Disorders

Neutropenia is categorized as severe if the absolute neutrophil count ([%segs + %bands] * WBC) is less than 500/mm3.  If the ANC is between 500/mm3 and 1000/mm3, the neutropenia is moderate.   An ANC between 1000/mm3 and 1500/mm3 is considered mild neutropenia, although some people's normal neutrophil counts may fall into this range, particular people of African ancestry.  The ANC trend on serial CBCs may be more important than the absolute value; for example, a patient who has received chemotherapy and whose ANC is 1200/mm3 but falling rapidly needs antibiotics more than someone whose baseline ANC is 1100/mm3.