Simple hematological tests for diagnosis of neonatal sepsis

Simple hematological tests, TLC, DLC, mESR, platelet count, were performed in 128 neonates of which 50 were controls and 78 were cases of suspected septicemia. Thirty three had positive blood cultures and were taken as 'proved' and remaining as 'probable' sepsis. A band cell neutrophil (B/N) ratio of greater than 0.2 was most sensitive index (92%) followed by raised mESR of greater than 8 mm for 1st hour, whereas leukopenia of greater than 5 x 10(3)/mm3 was most specific index (88%) for the diagnosis of sepsis. Thrombocytopenia of less than 1.5 x 10(5)/cu mm was also taken as positive test for sepsis. A combination of three positive tests had highest positive predictive accuracy (94%) for early diagnosis of sepsis, when compared to single test or two positive test combinations. The best combination of tests was B/N ratio, leukopenia and mESR which can be easily done in a side laboratory.