COMPLETE BLOOD COUNT

Purpose: A complete blood count is a basic screening test and is one of the most frequently
order laboratory procedure. The findings in the complete blood count give valuable
diagnostic information about the hematologic and other body systems, prognosis, response
to treatment and recovery.

Date:

9/13/1
4
17:37
10.4

9/16/
14
22:30
8.81

9/19/
14
16:01
16.1 H

NEU

4.29
41.3

1.89 L
21.4 L

6.45
40.0 L

LYM

4.92
47.3

5.33 H
60.5 H

7.70 H
47.7 H

MONO

0.920
8.84

0.728
8.27

1.10
6.80

EOS

0.003
0.032

0.650
H
7.37 H

0.528
H
3.27

BASO

0.271
H
2.60

0.221
H
2.50 H

0.347
H
2.15 H

RBC

4.65

3.97 L

5.33

HGB

11.9 L

10.5 L

14.5

HCT

35.5 L

30.1 L

41.8

MCV

76.3 L

75.8 L

78.5 L

MCH

25.7 L

26.4

27.2

MCHC

33.7

34.8

34.6

RDW

11.4 L

11.5 L

13.2

PLT

434

440

346

MPV

4.79

4.91

4.66

WBC

Normal
Values
4.10
10.9 k/uL
2.50
7.50
47.0
80.0%
1.00 4.00
13.0
40.0%
0.10
1.20
2.00
11.0%
1.0 - .
500
0.00
5.00%
0.00 - .
100
0.00
2.00%
4.50
5.90
m/uL
13.5
17.5
g/dL
41.0
53.0 %
80.0
100. fL
26.0
34.0 pg
31.0
36.0
g/dL
11.6
18.0 %
140
440 k/uL
0.00
99.9 fL

IMPLICATIONS
Increased
WBC,
low
neutrophil,
and
high
lymphocyte indicates that
the immune system is
fighting
against
inflammation (pneumonia).

A high basophil and eosinophil count may indicate allergic reactions or inflammation
in the body.
Low RBC, HCT, HGB, MCV and RDW may mean the body may not be getting the
oxygen it needs. The low level of HGB indicates that the blood is not able to carry
much oxygen throughout the body.

ARTERIAL BLOOD GLASS REPORT

Purpose: This measures the acidity (pH) and the levels of O 2 and CO2 in the blood from an
artery. This test is used to check how well your lungs are able to move oxygen into the blood
and remove CO2 from the blood. An ABG measures:
Partial pressure of O2 (PaO2): measures the pressure of oxygen dissolved in the blood
and how well oxygen is able to move from the airspace of the lungs into the blood
Partial pressure of CO2 (PaCO2): measures how much carbon dioxide is dissolved in
the blood and how well carbon dioxide is able to move out of the body
pH: measures hydrogen ions (H+) in blood
bicarbonate (HCO3): a chemical buffer that keeps the pH of blood from becoming too
acidic or too basic
GROUP
RH
Oxygen content (TCO2): measures the amount of
Result
A
+
oxygen in the blood
Oxygen saturation (O2 sat): measures how much HGB in the red blood cells is
carrying oxygen

pH
pCO2
pO2
HCO3
TCO2
Sat.
O2

9/13
7.291
35.3
250
17.3
16.3
100 %

Result
9/14
7.35
39
84
21.3
19.5
100.6 %

Normal Values
7.378
31.0
203
19.5
17.0
98.9 %

7.35 7.45
32 42 mmHg
75 100 mmHg
20 24 mmol/L
21 25 mmol/L
95 98 %

BLOOD TYPING
PURPOSE: To determine what kind of antigen and antibody is/are present in the blood
Date: 9/18/14

Implication: Type A has only the A antigen on the red blood cells and B antibody in the
plasma.
BLOOD CHEMISTRY
PURPOSE:
CALCIUM (IONIZED)
PURPOSE: Typically, a serum calcium test is performed to check the total amount of calcium
in your blood. This includes ionized calcium as well as all the calcium bound to proteins .To
help diagnose and evaluate a number of conditions that affect the bones, heart, nerves,

kidneys, and teeth. The test may also be done to monitor progress and treatment of these
diseases.
DATE: 9/13/14
TEST
RESULT
NORMAL VALUE
Calcium (Ionized)
[H] 5.2 mg%
4.6-5.1 mg%
Implication:
Ionized calcium binds to negatively charged sites on protein molecules, competing with
hydrogen ions for the same binding sites on albumin and other calcium-binding protein. This
binding is pH dependent and alters the level of ionized calcium in the blood. Acidosis
decreases protein binding, resulting in increased free calcium levels.

CHEST XRAY
PURPOSE: Chest X-ray is a type of diagnostic radiology procedure used to examine the chest
and the organs and structures located in the chest. Chest X-rays may be used to assess the
lungs, as well as the heart (either directly or indirectly) by looking at the heart itself. Certain
conditions of the heart may cause changes in the lungs and/or the vessels of the lungs.
Changes in the normal structure of the heart, lungs, and/or lung vessels may indicate
disease or other conditions.
Chest X-rays may provide important information regarding the size, shape, contour, and
anatomic location of the heart, lungs, bronchi, great vessels (aorta, aortic arch, pulmonary
arteries), mediastinum (an area in the middle of the chest separating the lungs), and the
bones (cervical and thoracic spine, clavicles, shoulder girdle, and ribs).
DATE: 9/13/14
RESULT: Examination reveals there are reticular & patchy densities in both lungs. The cardiac
silhouette is not enlarged. There are no abnormalities. ET is in good position.
CONCLUSION: Bilateral pneumonia. Suggest reray in 7-10 days as a follow up study. ET in
good conclusion.
RESULT: examination reveals there are patchy densities noted in both lungs. The cardiac
silhouette is not enlarged. There are no bony abnormalities. There is a ET in good position. A
comparative study with the earlier film taken on September 13,2014 fails to show
improvement.
CONCLUSION: Pneumonia in both lungs. Suggest reray in a period of 7-10 days as a follow up
study.
Implications:
The densities in the lungs are caused by the filling of lungs with fluid called consolidation,
which is characteristic of pneumonia. If consolidation becomes worse and untreated, lifethreatening hypoxia can occur.
ANTIMICROBIAL SUSCEPTIBILITY TESTING
PURPOSE: Antimicrobial susceptibility tests are used to determine which specific antibiotics
a particular bacteria or fungus is sensitive to. Most often, this testing complements a Gram
stain and culture, the results of which are obtained much sooner. Antimicrobial susceptibility
tests can guide the physician in drug choice and dosage for difficult-to-treat infections.
DATE: 9/17/14

SPECIMEN: Tracheal aspirate

MICROORGANISM: Streptococcus viridans
Reading:
Sen - Sensitive
Int - Intermediate
Res - Resistant
Antibiotic
3rd Generation
Ceftriaxone
4th Generation
Cefepime
Fluroquinolones
Levofloxacin
Ofloxacin
Macrolides
Azithromycin
Erythromycin
Others
Chloramphenicol
Clindamycin
Linezolid
Tetracyline
Vancomycin

Disc
content
(g)

Result

30 g

Res

30 g

Res

5 g
5 g

Sen
Sen

15 g
15 g

Int
Res

30 g
2 g
30 g
30 g
30 g

Sen
Sen
Sen
Sen
Res

Implications:
Sensitive - indicates that the antimicrobial agent in question may be an appropriate choice
for treating the infection caused by the bacterial isolate tested. S. viridans is sensitive to
Levofloxacin, Ofloxacin, Chloramphenicol, Clindamycin, Linezolid, Tetracyline.
Intermediate - the antimicrobial agent may still be effective against the tested isolate but
usually at higher concentrations. S. viridans is intermediate to Azithromycin.
Resistant - indicates the antimicrobial agent in question may not be an appropriate choice
for treating the infection caused by the bacterial isolate tested. S. viridans is resistant to
Ceftriaxone, Cefepime, Erythromycin, Vancomycin.
DIAGNOSTIC MICROBIOLOGY
BLOOD CULTURE
PURPOSE: A blood culture is a test to find an infection in the blood. The blood does not
normally have any bacteria or fungi in it. A blood culture can show what bacteria or fungi are
in the blood.
DATE
9/14/14
9/15/14
9/16/14
9/17/14
9/18/14
Implication:

RESULT
Preliminary Report:
No growth after 1 day of incubation
P.R. No growth after 2 days of incubation
P.R. No growth after 3 days of incubation
P.R. No growth after 4 days of incubation
F.R. No growth after 5 days of incubation

No bacterial growth noted after 5 days of incubation.

CULTURE AND SENSITIVITY
This test determines the type of organism causing the cellulitis, if it is spreading to the
blood, as well as which antibiotics would be most effective in treating it.
DATE
RESULT
9/14/14
Gram (+) cocci in pairs rare
Pus cells: few
9/15/14
9/16/14
9/17/14

9/19/14

P.R. no growth after 1 day of incubation

P.R. colonies count: less than 10,000 cfu/ml
After 48 hours of incubation
P.R. culture in progress
P.R. Smear of culture: gram (+) cocci in pairs
REMARKS: 1. Sensitivity test result of gram (+) cocci
in pairs
2. Identification of gram (+) cocci in
pairs to follow
F.R. Culture: Streptococcus viridans

Implications:
Streptococcus viridans is a member of the Streptococcus group and are most prevalent in
the oral cavity but also reside in the upper respiratory tract, the female genital tract, and all
regions of the gastrointestinal tract; they also are occasionally found as part of the skin flora.
Although they are commensal organisms in these sites, these microorganisms may also
invade sterile body sites, which can lead to life-threatening diseases (e.g., endocarditis,
meningitis, and pneumonia). They typically cause significant infection only when the oral
mucosa is significantly disrupted and host defense mechanisms are compromised.
LIVER FUNCTION TEST
PURPOSE: Liver tests are performed to determine if the liver is working correctly. The liver
performs a number of vital bodily functions, such as:
removing contaminants from the blood
converting the nutrients from the food you eat
storing minerals and vitamins
regulating blood clotting
producing proteins, enzymes, and bile
making factors that fight infection
removing bacteria from the blood
processing substances that could harm the body
maintaining hormone balances
DATE: 9/13/14
TEST
TOTAL PROTEIN
ALBUMIN
GLOBULIN
A/G RATIO
IMPLICATIONS:

RESULT
6.4 g/dl [L]
4.11 g/dl
2.2 g/dl [L]
1:5

NORMAL VALUE
6.6 8.8 g/dl
3.80 - 5.10 g/dl
2.8 - 3.7 g/dl
----

Inflammation lowers the albumin levels by forcing the liver to divert some of its albumin
production and make other proteins that are needed for the immune response. Either acute
or chronic inflammation may lead to abnormally low albumin levels.