Does my segmenter value of 0.68 on CBC indicate sepsis?

Question

Hello doctor,

I have had tonsillitis for almost one month now. I went to the clinic a few days ago, and the doctor prescribed me Azithromycin (a macrolide antibiotic) for five days. Today is my fifth day of taking the medication. However, two days before I went to the doctor, I started experiencing chills that came and went during both the day and night.

I do not have any other symptoms such as fever or headache, but yesterday I developed watery stools.

My complete blood count (CBC) result from my last clinic visit showed that my segmenters were 0.68, which is above the normal range of 0.45–0.65.

Please tell me,

Can this be sepsis?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Given that you have had persistent tonsillitis for nearly one month, and are now on your fifth day of Azithromycin (macrolide antibiotic) with ongoing chills but no fever or severe systemic symptoms, it is essential to evaluate your response to treatment carefully. While the elevated segmenters (neutrophils) on your complete blood count (CBC) suggest a bacterial component, this finding is not uncommon during infections and does not, on its own, confirm sepsis.

Sepsis typically presents with high or low fever, rapid heartbeat, rapid breathing, confusion, and low blood pressure, none of which you have described. However, chills that persist despite antibiotic treatment can indicate an inadequate response to therapy, a resistant organism, or possibly another site of infection. Your watery stool may also suggest gastrointestinal involvement, which could be due to the infection itself or as a side effect of the antibiotic.

I recommend a thorough investigation:

CBC.
Throat culture or rapid strep test.
C-reactive protein (CRP) or procalcitonin testing

In some cases of chronic or recurrent tonsillitis, especially when unresponsive to antibiotics, a referral for tonsillectomy may be considered. In the meantime, you should complete your antibiotic course, maintain good hydration, avoid irritants such as smoking, and monitor for red flag signs such as persistent high fever, difficulty swallowing, drooling, neck stiffness, or confusion, which would require urgent medical attention.

I hope this helps.

Thank you.