Q: My child keeps vomiting and has a WBC count of 35,000. Should we return to the ER?
- Myeongchan Kim
- 1 day ago
- 2 min read
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My child started vomiting continuously yesterday evening, so we went to the ER. They administered an antiemetic, which helped slightly, but my child still vomits whenever they wake up. The ER doctor noted that the white blood cell (WBC) count is 35,000, mentioned the possibility of leukemia, and advised us to follow up at the outpatient clinic on Monday. If the vomiting and abdominal pain continue, should we go to another ER that can admit us today? We were prescribed oral antibiotics, but I don't think my child can keep them down due to the vomiting.
Answer:
I understand how incredibly worried you must be hearing about a white blood cell count of 35,000 and having the ER mention the possibility of leukemia.
To evaluate the current situation: While a WBC count of 35,000 is higher than the normal range (usually 5,000–15,000), a significant, temporary spike like this can also frequently occur during severe, acute infections. Right now, the most pressing concern is the risk of dehydration from continuous vomiting and the inability to take the prescribed antibiotics.
You should return to the emergency room immediately today if you observe any of the following:
• No urine output for more than 8 hours
• Dry lips and no tears when crying
• Severe lethargy or lack of responsiveness
• Complete inability to keep medications or fluids down due to vomiting
• Worsening or severe abdominal pain
If none of these danger signs are present and you are observing your child at home, focus on hydration by offering 1 to 2 small sips of water or an oral rehydration solution every 5 to 10 minutes. You can attempt to give the antibiotics with a small amount of water about 30 minutes after a vomiting episode. Be sure to keep a careful record of your child's body temperature and how often they urinate.
The WBC count will need to be accurately re-evaluated through follow-up blood tests at your outpatient clinic visit on Monday. Keep in mind that there is a strong possibility this is a temporary elevation due to an infection. For now, preventing dehydration is your top priority. If your child cannot stay hydrated, cannot take their medication, or if their symptoms worsen, please seek in-person medical evaluation at an ER that can admit patients right away.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
