TY - CHAP M1 - Book, Section TI - LYMPHOPENIA AND IMMUNE DEFICIENCY A1 - Hillman, Robert S. A1 - Ault, Kenneth A. A1 - Leporrier, Michel A1 - Rinder, Henry M. PY - 2016 T2 - Hematology in Clinical Practice, 5e AB - CASE HISTORY • Part 1A 23-year-old woman presents with recurrent episodes of sinusitis, a well-documented pneumococcal pneumonia at age 17, and a chronic productive cough for over a year; the latter has not responded to several courses of antibiotics. She has lost 10 lbs over the last 6 months and feels chronically ill. Her sexual history includes unprotected sex with at least 5 different males over the last 4 years.On examination, she is afebrile with normal vital signs but appears poorly nourished and chronically ill. She has palpable, slightly enlarged, non-tender cervical lymph nodes and a palpable spleen without hepatomegaly. Chest examination is remarkable for prominent rhonchi and crackles throughout the lower lung fields, without signs of pleural fluid or consolidation. Fingers appear to be slightly clubbed. A routine complete blood count (CBC) is drawn and chest film obtained:CBC: Hematocrit/hemoglobin - 33%/11 g/dLTable Graphic Jump Location|Download (.pdf)|PrintMCV - 93 fLMCH - 31 pgMCHC - 33 g/dLWBC count - 10,900/μLDifferential:Neutrophils - 7,500/μLLymphocytes - 2,450/μLMonocytes - 850/μLEosinophils - 100/μLPlatelets - 35,000/μLChest film: Nonspecific scarring in both lower lobes. No evidence of consolidation or pleural fluid.QuestionsDo the history and physical examination suggest a diagnosis?What abnormalities are apparent from the CBC?What additional workup is in order? SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/03/29 UR - accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127767375 ER -