1. Unit 2 - Mechanisms of Self Defence: Immunity and Infection
Group B
Tammy, Heather and Merissa

2. Question
If the neutrophil count was high in a WBC differential, what kind of infection would you suspect? If the lymphocyte count was high?

3. Neutrophils
neutrophils arrive to the site of inflammation or injury within 6 to 12 hours (McCance & Huether, 2006).
Neutrophils have the ability to release chemical mediators to destroy microorganisms (Copstead & Banasik, 2000).

4. Band Cells Immature neutrophils are called bands or stabs
An increase in these cells indicates that the bone marrow has depleted its store of mature neutrophils
The term “a shift to the left” is used when band cells are elevated (Borton, 1996)
An elevation of band cells may be reflective of an infectious process.

5. Lymphocytes
Lymphocytes are nonphagocytes of the adaptive immune response and the two types are T lymphocytes and B lymphocytes(McCance & Huether, 2006).
T and B lymphocytes have the ability to recognize foreign antigens found in the environment and each individual T or B lymphocyte recognizes one particular antigen (McCance & Huether, 2006).
T lymphocytes are released from the thymus and B lymphocytes are released from the bone marrow (McCance & Huether, 2006).

6. What kind of infections increase neutrophils?
you would suspect an early, acute stage of an infectious process
neutrophil counts may also be elevated with non-infectious inflammatory states
acute myocardial infarction
diabetic ketoacidosis
acute hemorrhage
corticosteroid use

7. What kind of infections increase neutrophils?
Neutrophil would also be increased in:
malignant tumors
kidney infections
hemolytic anemia
post operatively
Influenza

8. What kind of infections increase lymphocytes?
Lymphocytes are increased during severe infection, cancer of the blood or lymphatic system and autoimmune disorders that cause chronic inflammation (Mayoclinic, 2009).
acute infection – example mononucleosis
chronic infection – example congenital syphilis
malignant process such as Acute Lymphocytic Leukemia or Chronic Lymphocytic Leukemia (Mayoclinic.com).

9. What kind of infections increase lymphocytes?
Increased lymphocytes are seen in patients with
Tuberculosis
Mumps
rubella
crohn's disease
herpes simplex
Hepatitis
Lymphocytes can also rise after blood transfusions
(Carone, 2009)

10. Making Sense of it all in clinical situations

11. Case Study
Jason Hornbuckle is not a happy little boy. For the past 12 hours he has complained of pain when he swallows, has a headache, and has vomited twice. His mother decides to take the seven-year-old to his pediatrician. Upon examining Jason, the doctor finds that Jason’s pharynx, tonsils, and uvula are swollen and erythematous (red) and his tonsils are studded with white areas of exudate. He is febrile (temperature 40.3 degrees centigrade) with tender, bilateral, cervical lymphadenopathy (enlarged lymph nodes).
A Complete Blood Count (CBC) performed on a sample of Jason’s blood reveals that he has a leukocytosis (increased number of WBCs) due to a neutrophila (increased number of neutrophils).
Jason is diagnosed as having acute bacterial pharyngitis and treated with phenoxymethyl penicillin for five days. A throat swab taken before starting antibiotics grows beta-hemolytic streptococci (Group A). After three days of treatment, Jason’s temperature has returned to normal and he has made an uneventful recovery.
Dean (2009)

12. Question
The exudate on Jason’s tonsils consisted primarily of neutrophils, and the CBC that was performed indicated that the number of neutrophils in his circulation was increased. What role do neutrophils play in the resolution of a bacterial infection?
Dean (2009)

13. What diseases and infections decrease neutrophils and lymphocytes?
Discussion Question
Our group has discussed what increases neutrophils and lymphocytes but….
What diseases and infections decrease neutrophils and lymphocytes?

15. References
Borton, D. (1996). WBC count and differential. Nursing ’96, 26(9)
Brashers, V. (2006). Innate Immunity. Elsevier Mobsy.
Britannica. (2009). Human lymphocyte. Retrieved January 10, 2009 from:
Carone, D. (2009). Medfriendly. retrieved January 9, 2009 from:
Copstead, L. C., & Banasik, J. (2000). Pathophysiology: Biological and behavioral perspectives. (2nd ed.). Philadelphia, PA: W.B. Saunders Company.
Dean, D. (2009). A case of Pharyngitis. Spring Hill College. Retrieved January 14, 2008 from:

16. References
Doctor NDTV (2007). Why is my neutrophil count high? Retrieved online January 8, 2009 from
Google images. (2009). Retrieved January 10, 2009 from: faculty.une.edu/com/abell/histo/histolab3a.htm
Hicks, M. (2009). Clip Art Gallery. Retrieved January 12, 2009 from: school.discoveryeducation.com/clipart/clip/th...
Mayoclinic.com: Blood and lymphatic system. Retrieved online January 8, 2009 from
McCanace, K., & Huether, S. (2006). Pathophysiology: The biologic basis for disease in adults and children. (5th ed.). St. Louis, MI: Elsevier Mosby.