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Dear Dr. Roach: I am a 22-year-old male. I recently had a 103-degree fever with cold and cough symptoms, and my doctor ordered a complete blood count. After my results came back, he said it is normal, but there is 10.6 percent lymph (normal is 20 to 40 percent), and a total white blood cell count of 5.6. Should I be worried? -- D.A.
Answer: The lymphocytes are one of the types of white blood cells. In some types of illnesses, they can dip down from their normal level. A normal level of a lymphocyte count is 1,500 to 2,000; your result is 10.6 percent of 5,600 (the 5.6 refers to thousands), so about 600. This is common to see in some people with viral infections, and your doctor probably will want to recheck it after you recover from your flulike illness.
HIV is a virus that can infect the lymphocytes themselves. The Centers for Disease Control and Prevention recommends that HIV testing be routine for adults, and I agree. You should have an HIV test, especially since one possibility for low lymphocyte count is HIV infection.
Dear Dr. Roach: In a recent column, you advised someone to get the shingles shot unless she had an immune system disease. I am 63 and have been considering getting the shot. Now I am hesitating because I have lichen planus. I believe this is immune-system related. Is it? Should I not get the vaccine? -- R.M.
Answer: Many conditions, including lichen planus, are thought to have a disordered, overactive immune system as part of their cause. However, what I meant as far as getting live vaccines like shingles was caution from those with serious damage to the immune system. In your case, I would recommend to get the vaccine.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.