Elevated band count in the pediatric patient

IntroductionIn this review article we survey the literature for current evidence in pediatric practice regarding the use of elevated band count in the pediatric emergency room. In addition, we present data from the literature on the wide variability of manual band counts to reconsider its utility in...

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Main Authors: Aaron Grubner, Jennifer E. Sanders, Regina M. Longley, Maria Vergara-Lluri
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1483929/full
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author Aaron Grubner
Aaron Grubner
Jennifer E. Sanders
Jennifer E. Sanders
Regina M. Longley
Maria Vergara-Lluri
author_facet Aaron Grubner
Aaron Grubner
Jennifer E. Sanders
Jennifer E. Sanders
Regina M. Longley
Maria Vergara-Lluri
author_sort Aaron Grubner
collection DOAJ
description IntroductionIn this review article we survey the literature for current evidence in pediatric practice regarding the use of elevated band count in the pediatric emergency room. In addition, we present data from the literature on the wide variability of manual band counts to reconsider its utility in clinical practice.BackgroundBandemia is commonly seen during a state of infection. Band count is determined by manual cell count and can be prone to inaccuracy and imprecision. Despite its shortcomings, the 100-cell manual differential count remains the most practical method for assessing left shift.MethodsAll the literature involving the use of elevated band count as a biomarker in pediatrics available on PubMed and Google Scholar was surveyed. “Bandemia”, “Band count”, “left shift” and “immature neutrophils” were used as primary search terms, in conjunction with the term “pediatrics.”ResultsThe most recent AAP guidelines do not incorporate band count in decision making for febrile neonates. Elevated band count is related to worse outcomes in non-operative management of appendicitis. Elevated band count can be seen in viral illness alone. Even severe bandemia (<20%) does not correlate with severe illness.DiscussionMore studies are needed to definitively dispel the notion of bandemia and its association with invasive bacterial infection. Additionally, pediatric providers may benefit from professional society guidelines advising appropriate management of the pediatric patient with elevated band count.
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spelling doaj-art-5a00a637d2e14090817eb15bb4ad855f2025-08-20T02:56:09ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-05-011310.3389/fped.2025.14839291483929Elevated band count in the pediatric patientAaron Grubner0Aaron Grubner1Jennifer E. Sanders2Jennifer E. Sanders3Regina M. Longley4Maria Vergara-Lluri5Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesIcahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesIntroductionIn this review article we survey the literature for current evidence in pediatric practice regarding the use of elevated band count in the pediatric emergency room. In addition, we present data from the literature on the wide variability of manual band counts to reconsider its utility in clinical practice.BackgroundBandemia is commonly seen during a state of infection. Band count is determined by manual cell count and can be prone to inaccuracy and imprecision. Despite its shortcomings, the 100-cell manual differential count remains the most practical method for assessing left shift.MethodsAll the literature involving the use of elevated band count as a biomarker in pediatrics available on PubMed and Google Scholar was surveyed. “Bandemia”, “Band count”, “left shift” and “immature neutrophils” were used as primary search terms, in conjunction with the term “pediatrics.”ResultsThe most recent AAP guidelines do not incorporate band count in decision making for febrile neonates. Elevated band count is related to worse outcomes in non-operative management of appendicitis. Elevated band count can be seen in viral illness alone. Even severe bandemia (<20%) does not correlate with severe illness.DiscussionMore studies are needed to definitively dispel the notion of bandemia and its association with invasive bacterial infection. Additionally, pediatric providers may benefit from professional society guidelines advising appropriate management of the pediatric patient with elevated band count.https://www.frontiersin.org/articles/10.3389/fped.2025.1483929/fullbandemiaband countleft shiftpediatricsimmature neutrophils
spellingShingle Aaron Grubner
Aaron Grubner
Jennifer E. Sanders
Jennifer E. Sanders
Regina M. Longley
Maria Vergara-Lluri
Elevated band count in the pediatric patient
Frontiers in Pediatrics
bandemia
band count
left shift
pediatrics
immature neutrophils
title Elevated band count in the pediatric patient
title_full Elevated band count in the pediatric patient
title_fullStr Elevated band count in the pediatric patient
title_full_unstemmed Elevated band count in the pediatric patient
title_short Elevated band count in the pediatric patient
title_sort elevated band count in the pediatric patient
topic bandemia
band count
left shift
pediatrics
immature neutrophils
url https://www.frontiersin.org/articles/10.3389/fped.2025.1483929/full
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