• Amit Frenkel, Eric Kachko, Karin Cohen, Victor Novack, and Nimrod Maimon.
• Intensive Care Unit, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. Electronic address: frenkela@bgu.ac.il.
• Am J Emerg Med. 2018 May 1; 36 (5): 749-753.

BackgroundGlucocorticosteroids (GCS) are known to cause the hematologic effect of leukocytosis and neutrophilia. Leukocytosis is a key parameter in establishing the diagnosis of sepsis and in the estimation of its severity.ObjectiveTo quantify the effect of chronic or acute GCS treatment on the level of leukocytosis in patients with acute infectious process.MethodsWe conducted a retrospective cohort study of patients with an acute infection hospitalized in tertiary medical center between the years 2003-2014. Patients were classified into three categories: chronic GCS treatment, acute GCS treatment, no GCS treatment. The primary outcome was the maximal WBC count within the first 24h from admission.ResultsWe identified 5468 patients with acute infection: 333 of them with chronic GCS treatment, 213 with acute GCS treatment and 4922 with no GCS treatment. The overall maximal leukocytes count was higher in GCS therapy groups: 15.4±8.3×109/L for the acute GCS treatment, 14.9±7.4×109/L for chronic GCS treatment and 12.9±6.4×109/L for the no GCS group (P<0.001).ConclusionIn patients with acute infections chronically treated with GCS, an increase in the WBC is at average of 5×109/L. These data must be taken into consideration while using the level of leukocytosis as a parameter in the diagnosis of the infectious process.Copyright © 2017 Elsevier Inc. All rights reserved.

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