Real People Stories – Olga

General CBC blood test in a child: what to pay attention to and how to distinguish viral from bacterial yourself.

In winter, during the cold season, a complete blood count (CBC) is one of the key diagnostic procedures that will help you choose the right treatment. I will now skip the importance of this exam for adults and want to focus specifically on children because (and every second mother will confirm this) paediatricians are now prescribing antibiotics to children left and right for every sneeze. What, you’ve been sick for 6 days – you already need an antibiotic! And they make these prescriptions without CBC tests and sometimes even without an examination!

Like many mothers, I am against the wholesale prescription of antibiotics. Yes, sometimes you can’t do without them, but I believe there must be good reasons for prescribing them.

Why do doctors prescribe antibiotics to children?

Before prescribing antibiotics, a competent CBC doctor will always send for a general lab test with a leukocyte formula. However, due to a heavy workload and lack of motivation, prescriptions are often made “from the clinical picture” without tests because the disease has dragged on (we are now taking respiratory diseases). Yes, in some cases, a viral infection that has not received adequate treatment turns into a bacterial one, or a bacterial one joins it. But I am sure that the doctor must see confirmation of this. Antibiotics do not work against viruses, and their resistance in humanity is growing slowly. Therefore, if a doctor prescribes antibiotics to a child, focusing only on the duration of the disease, look for another doctor. Or take a general review, analyse it and only then decide whether you agree with the doctor.

Our History

My daughter is 7 years old. I can’t call her a sickly child. Her colds go away quickly, often even without medication (with nutraceutical support). The last time, we both woke up with a sore throat, a low temperature, and a runny nose. We stayed home for a few days; the temperature returned to normal, the sore throat stopped hurting, and I decided my daughter could attend synchronised swimming training. The next morning, the child woke up feeling unwell and with a temperature. We stayed at home again, and everything was fine on the weekend. On Monday, I sent her to school, where she returned with a runny nose and a temperature of 38.6.

Someone will say that a bad mother, instead of leaving the child at home and treating him properly, drags him to the pool, then to school, and does not even treat him properly. But, I repeat, my child is hardened and has never been sick for more than 2-3 days. I sincerely believed that this time, it would be the same. But I was wrong—it happens to everyone.

Deciding to Visit the Pediatrician

After such swings with the temperature increase, I needed to visit a pediatrician, especially since the runny nose worsened. But before making an appointment, I decided to come up with an argument in the form of a CBC clinical blood test.

Like all blood exams, this one is given on an empty stomach, although they write that this is unnecessary. However, it is okay for me to get up early and give blood on an empty stomach.

Taking blood from a vein is a standard procedure. In our medical centre, instead of a couch, there is a folding chair where you can lie down (I know this is important to someone). We have donated blood from a vein to my daughter three times in her life, always for a fee, so my child tolerates the procedure easily and calmly. But you still need to sit her on your lap and hold her so she does not flinch when the needle is inserted.

After Analysis

Some people show huge bruises after taking the test. I have never had this, but I know that for some time after taking the test, you can’t straighten your arm, and you have to do it slowly.

Another thing that can happen is that a significant amount of blood is taken, making you dizzy. To prevent this, you can take the test lying down and preferably drink some water beforehand so that the blood becomes more fluid and fills the tubes faster. Sometimes, dizziness is a purely psychosomatic factor. When people see that it is barely flowing or that much is taken, they feel sick.

How to Evaluate the Results

When I realised that I needed to be on my toes with medicine and better educate myself in this area, at least as an amateur, I bought a guide to decoding results. I have been using this for several years. With the help of this decoding, I analyse my family’s reports. I now know that the laboratory references indicated in a separate column of laboratory forms are different. This applies somewhat to a general blood test but has nuances, too.

If the task is to identify the type of infection by blood, then the important CBC indicators in the test are ESR, leukocytes, lymphocytes, and neutrophils. Everything except lymphocytes increases, sometimes significantly, with a bacterial infection. With a viral infection, on the contrary, lymphocytes (and monocytes) increase. Neutrophils and leukocytes decrease, while ESR may be within normal limits or slightly increased.

If you monitor the tests dynamically while the child is sick, then the CBC can be used to track the addition of a bacterial infection, if any. In this case, the number of band neutrophils increases (leukocyte formula shifts to the left), an increase in WBC leukocytes and an acceleration of the erythrocyte sedimentation rate (ESR) are visible. If the CBC readings are ambiguous or uninformative, you can additionally take a C-reactive protein test.

Our Results

From what glows red in the analysis:

  • Increased platelets, monocytes
  • Decreased lymphocytes, eosinophils
  • Slightly increased ESR

The overall picture corresponds to the acute phase of the inflammatory process. But its nature—viral or bacterial—is difficult to understand. It seems both, but I had doubts and went to the doctor.

After the analysis, the doctor said the CBC picture was borderline, more viral, but the bacterial component was also present. Prescriptions: symptomatic treatment of cough and sinusitis, plenty of fluids.