Fast Five Quiz: How Much Do You Know About Neutropenia?

Elwyn C. Cabebe, MD

Disclosures

November 22, 2017

Chronic, benign familial neutropenia is suggested by a history of long-standing neutropenia without an increased risk for infection. These patients do not generate increased leukocyte counts with infection, but they have fevers and other symptoms, such as tachycardia, when infected.

Common presenting symptoms of neutropenia include the following:

  • Low-grade fever

  • Sore mouth

  • Odynophagia

  • Gingival pain and swelling

  • Skin abscesses

  • Recurrent sinusitis and otitis

  • Symptoms of pneumonia (eg, cough, dyspnea)

  • Perirectal pain and irritation

Patients with agranulocytosis usually present with the following:

  • Sudden onset of malaise

  • Sudden onset of fever, possibly with chills and prostration

  • Stomatitis and periodontitis accompanied by pain

  • Pharyngitis, with difficulty in swallowing

In agranulocytosis, fever may be present. Rapid pulse and respiration may be evident. Hypotension and signs of septic shock may be apparent if infection has been present. Painful aphthous ulcers may be found in the oral cavity. Swollen and tender gums may be present. Usually, purulent discharge is not present because not enough neutrophils exist to form pus. Skin infections are associated with painful swelling, but erythema and suppuration are usually absent.

A patient with agranulocytosis may have experienced a recent viral infection, although such infections are rarely associated with severe neutropenia. Certain bacterial infections may also precede agranulocytosis.

For more on the presentation of neutropenia, read here.

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