Can you have sepsis even though your cbc is normal?

my white blood ceels were only like a couple points lower the normal starts at 20 and mine were 18 how do they diagnose sepsis isnt the only way to tell a blood culture the doc said well since your white blodd cells are low that means your not having a severe infection but idk i feel so sick and sicne he said my cbc was normal to him he did not do the blood culture!!!!! is that ok or waht do you think??????

You asked an incredibly complex question.

First of all, a white blood cell count of 18,000 white cells per cubic millimter (the usual units) is high. That assumes that the usual units are being used and not some other unit of measure. USUALLY, this indicates some kind of infection or response to physiologic stress. So if you are feeling ill, and if your white cell count is high, then you likely have an infection. The question is, though, is it an infection in the blood. That would be relatively rare. Any infection anywhere will raise your white cell count. So a blood culture is probably not necessary in an outpatient setting.

As for diagnosing "sepsis". THAT is complicated. Sepsis is a term that should probably not be used. What it refers to, though, is a ridiculously complex set of chemical reactions that occur in the body that cause a patient's own white blood cells to damage their own tissues. Any serious infection could cause this without any bacteria being in the blood, so yes you can have "sepsis" without any bacteria in the blood. And you can. likewise, have bacteria in the blood and not have "sepsis". This is a clinical diagnosis, not a diagnosis made by a positive blood culture. That said, "sepsis" (better referred to as the "Systemic Inflammatory Response Syndrome") is a VERY serious life threatening problem that can result in low blood pressure and multiple organ failures.

The same set of chemical reactions and serious consequences can also happen from a number of other causes such as large burns, massive blood transfusion, multiple fractures, massive crush injuries etc etc. In those cases, the white blood cells may not be elevated since no actual infection is involved (although they CAN be elevated as a response to the physiologic stress such problems cause).

So, are you confused yet? That's why it takes so dang long to become a practicing physician! WHEW!

So, the short answer to your question is that I doubt you are septic regardless of your white blood cell count or you would be in an ICU somewhere. Also, an increased white blood cell count does not, by itself, mean much of anything other then you PROBABLY have some kind of infection somewhere. That could be anything from a sore throat to a ruptured appendix. Also, you probably do not need a blood culture unless there is some specific reason to be concerned about a blood infection (such as, for example, having a long term IV catheter in place or a new heart murmur).

What really matters is that you feel lousy. The real question is not your white count or blood cultures. The real question is what is it that is wrong. Sore throat? Weak and dizzy? Abdominal pain? etc etc. THOSE are what your physician cares about. Based on those answers and on what is found on a exam, then he or she will order the appropriate tests to fit that set of signs and symptoms. And it is those signs and symptoms that will determine what the information in any test result means and what other tests might be needed next.

Long answer. By the way, if your CBC really was normal, that still does not mean you have or do not have an infection of some kind. My guess, if it really was normal, you probaly have a viral illness. These, generally, don't raise the white cell count as much as a bacterial infection. And a blood culture only finds bacteria in the blood, not viruses.

A WBC count of 18 is high, not low. WBC is 4-10. You have an infection. So, No, you can't have sepsis without it showing up in the blood.