Infection After Gynecologic Surgery: Implications of Racial Leukopenia in Black Women

Differences in the normal peripheral white blood cell count (WBC) among people of various racial backgrounds are well recognized, and one familiar example is the decrease in the WBC of African-Americans relative to that of Caucasian subjects, a phenomenon that has been termed "racial leukopenia." Since the WBC is commonly used as an early indicator of infection, information regarding this phenomenon is pertinent: Such leukopenia could give rise to a falsely low (i.e., in the normal range) WBC during a significant infectious event. We therefore conducted a retrospective study to describe the incidence of this leukopenia among Black women in Louisiana and to follow their WBC levels in response to infection after elective gynecologic surgery. We found that 6.5% of these women exhibited a preoperative WBC < 3.5 x 10^3 cells/mm3, which represents the lower limit of normal for this measure. Although these women did exhibit a 2- to 3-fold rise in their WBC in response to infection, their peak WBC remained less than 11.0 x 10^3/mm3, a value below the upper limit of normal.