72 y F with PMH breast CA with lung, liver, and bone metastasis, NSTEMI and 3rd degree heart block s/p pacemaker few years ago, and hx of DVT admitted for COPD exacerbation and neutropenia.
WBC on day#1, 2, and 3 was 1.6, 0.9, 2.4 respectively.
ANC on day#1, 2, and 3 was 1, 0.5, and 2 respectively.
Heme-onc was consulted on day number 1. They saw pt on day #2. They recommend repeat CBC. If ANC remained at 0.5, they would recommend Bone marrow biopsy for this patient. Fortunately, repeat labs on day 3 showed resolution of neutropenia. Heme-onc consultant predicted the resolution and stated that certain viral or bacterial infections can bring down the ANC but it would bounce back up shortly. Patient’s COPD improved and Heme-onc recommended d/w with f/u with heme-onc.