pt.suffer from pain abd.in Lt. hypochondriac region before 20days,there no h/o any other diseases

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It's CML , sepsis won't lead to wbc count this high , do bone marrow !

a case of hyper spleenesium in splenomegaly (? ? cause) to r / o infective mononucleosis or lymphoma or histoplasmosis.do ct abdomen, pelvis triple phase and all investigation including lft, rft, echo

its look like leukemoid reaction. investigate for leukemia. bone marrow biopsy and usg abdomen.and reports from two different satandard lab.must beacuse we are giving serious diagnosis .

such high wbc count without any serious illness..look for PBS for abnormal cells .Do pro calcitonin level to r/o sepsis .is he has fever spike? vitals?

do usg abdomen first ,repeat Cbc from good pathologist ..two opinion always better if that report also same then go farther....

Diagnosis is Anemia with sepsis. Rule out haemolytic causes of Anemia,Malaria Start higher end antibiotics,Npo if possible

Rule out Mylo proliferative disorder, do a cps. Any lymphadenopathy

lukemoid reaction due to pancreatitis should go for serum lipase

Dr.barve without PBS or BM biopsy ,how will you diagnose CML?

Dr.krishan mohan give ur valuable suggestion plz

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