View source for Bandemia

==Background==
*Bandemia (also referred to as a "left shift") refers to an excess of immature neutrophil precursor cells (band cells)
*The origin of the phrase "left shift," is commonly thought to stem from the left-most button arrangement of early cell sorting machines
*A left shift refers SPECIFICALLY to increase bands and not increased neutrophils, which can increase in the setting of seizure, MI, pain or any stress response.

==Clinical Features==
*There are no clinical features specific to bandemia
*Generally defined as >6% band cells on a CBC with differential

==Differential Diagnosis==
*Bandemia typically indicates a serious underlying inflammatory or infectious process
**[[sepsis]]

==Evaluation==
*Complete history and physical
**Look for any source of infection
***Consider decubitus ulcers
***Consider GU sources in women and young uncircumcised boys 
***Consider pulmonary source
***Consider GI source including gallbladder 

===Workup===
*Blood cultures, CBC, CMP, UA, viral swabs, CXR if respiratory symptoms
*Complete physical exam 

===Diagnosis===

==Management==


==Disposition==


==See Also==


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==References==
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