CBC Report Interpretation

Summary of Findings

Key Abnormalities Explained

1. Anaemia (Mild-Moderate)

• Hb 11.9 g/dL (low for a male; normal >13.0) with a low RBC (4.31) and low PCV (37.3%)
• MCV is normal (86.5 fL) → this is a normocytic anaemia
• Elevated RDW (15.6%) suggests anisocytosis - red cells are of mixed/unequal sizes, which can indicate early iron deficiency superimposed on another process, or a mixed deficiency (iron + B12/folate)

2. Thrombocytopenia (Low Platelets)

• Platelet count is 1.20 Lac/cu.mm (120,000/uL), below the normal range of 1.5-4.10 Lac
• PDW (25 fL) and MPV (14.10) are both elevated, suggesting platelet activation or large, immature platelets being released - this is often seen when the bone marrow is trying to compensate (reactive thrombocytopenia), or in early immune thrombocytopenia (ITP), dengue, viral illnesses, or hypersplenism

3. Relative Neutropenia with Lymphocytosis

• Neutrophils at 30% (low; normal 40-80%) with an ANC of only 1,842/cu.mm (below 2000 - borderline neutropenia)
• Lymphocytes elevated at 58% with absolute count of 3,561/cu.mm
• This pattern (low neutrophils, high lymphocytes) is a relative lymphocytosis - common in:
  • Viral infections (dengue, EBV, CMV, COVID-19)
  • Chronic infections (tuberculosis)
  • Autoimmune conditions
  • Less commonly: lymphoproliferative disorders (if absolute lymphocyte count were much higher)

Clinical Interpretation

1. Likely viral illness - The combination of low platelets + low/borderline neutrophils + high lymphocytes is classic for dengue fever, especially given the report is from India (endemic region) and dated today. This warrants an NS1 antigen and dengue IgM/IgG test immediately.
2. Normocytic anaemia with elevated RDW - Could represent early iron deficiency (before MCV drops), or a mixed deficiency. Further workup: serum ferritin, iron studies, B12, folate, peripheral blood smear.
3. Thrombocytopenia - Mild (platelet count 1.20 Lac). The large platelet size (high MPV and PDW) is reassuring that bone marrow is responding. Platelet count needs to be monitored closely, particularly if dengue is confirmed (platelet count can fall rapidly in dengue).

Recommended Next Steps

• Urgent: Dengue NS1 antigen, dengue serology (IgM/IgG)
• Peripheral blood smear examination
• Serum ferritin, iron studies, TIBC
• Vitamin B12 and folate levels
• Liver function tests (LFT) and renal function
• If lymphocytosis persists after recovery: consider peripheral smear for atypical lymphocytes; flow cytometry if indicated
• Repeat CBC in 48-72 hours to monitor platelet trend

Disclaimer: This interpretation is for informational purposes only and does not replace a clinical diagnosis. The treating physician should correlate these findings with the patient's symptoms, clinical examination, and medical history.