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What Does My Pathology Test Report Indicate?

Posted on Fri, 12 May 2017

Question: An elderly hospitalised relative had a pathology test a week ago with one of the results being "Vacuolated Neutrophils+". I understand that this test is a good predictor of sepsis. His WCC and CRP are up but I am told that a number of his conditions could be causing this. No other test. e.g blood cultures were done.. But what I don't understand is that, although the relative is quite unwell, he doesn't seem to be any worse than a week ago. Could the result "Vacuolated Neutrophils+" have simply been wrong or is it possible that the test can detect an infection (example?) that takes a week or more to make a patient visibly worse? He has not been administered antibiotics.

Answered by Dr. Hardik Sanghvi (2 hours later)

Brief Answer:
It can be due to some infection.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.

She has vacuolated neutrophils. It is commonly seen in infection. But it should be correlated with CRP and clinical condition.
It can be due to past infection.

So if patient is clinically better then nothing to worry about infection and vacuolated neutrophils.

Just go for follow up CRP. It will become normal within few days.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Hardik Sanghvi (3 hours later)

Thank you Dr Sanghvi! The patient who is still in hospital was recently diagnosed with pneumonia and was thought to have recovered from the condition. However, the WBC remained elevated and the CRP is definitely rising again. I realise that the WCC and CRP are non-specific. The physical symptoms do not seem to be any worse than a week ago, although the patient is still unwell. If the person didn't fully recover from the previous infection or has a new one then is it possible for an infection not to make the patient visibly much worse a week after the vacuolated neutrophil+ result came through or is this very unlikely? Thank you very much for your help.

Answered by Dr. Hardik Sanghvi (18 hours later)

Brief Answer:
It is possible that vacuolated neutrophils not correlated with clinical.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.

Her vacuolated neutrophils may not match with clinical condition. It is not a reliable indicator every time.

Crp may rise after 24 of infection and remains elevated few days. So your patient may have past infection or new infection.

Just follow up with CRP. If it is rising then patient may have fresh infection and she need antibiotics.

If it is falling then it is ok. Nothing to worry.

If still there is doubt then she can go fir pro calcitonin. It us other inflammatory marker. Vacuolated neutrophils is not a reliable indicator for disease progression or regression.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar