Correlation of White Blood Cell Count and Hemoglobin Levels with Disease Severity in Pediatric Otitis Media Correlation of White Blood Cell Count and Hemoglobin Levels
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Abstract
Pediatric otitis media is a widespread infectious disease, where systemic inflammatory reactions can affect disease severity, and the evaluation of white blood cell count and hemoglobin levels might be useful markers of inflammatory load and disease progression. This study aimed to assess the relationship between disease severity and white blood cell count and hemoglobin levels in pediatric otitis media, and approve their potential as simple indicators of disease severity. This hospital-based case-control study was conducted from 13 April to 20 November 2025 in the ENT Consultancy Unit of Al-Habboubi Teaching Hospital, Iraq. The study included 75 children clinically diagnosed with otitis media and 30 age- and sex-matched healthy controls under 12 years of age. Diagnosis was established by otoscopic examination. Bacterial identification from middle ear samples was performed using standard culture media. Hematological parameters were determined using automated analyzers, and disease severity was classified into mild, moderate, and severe forms. Baseline comparability between patients and controls was adequate, with no significant differences in sociodemographic characteristics. The most common pathogen identified was Streptococcus pneumoniae, followed by Haemophilus influenzae and Moraxella catarrhalis. Patients showed significantly higher white blood cell counts and neutrophil proportions, accompanied by lower hemoglobin and lymphocyte levels, indicating a neutrophil-dominant inflammatory response. White blood cell and neutrophil counts were positively correlated with disease severity, whereas hemoglobin and lymphocyte levels showed negative correlations, suggesting inflammation-related anemia in severe cases. In conclusion, this study showed that pediatric otitis media associated with severity-related systemic inflammation characterized by elevated white blood cell and neutrophil counts and reduced hemoglobin levels. These findings reflect inflammatory anemia mediated by cytokine activity and hepcidin-related iron sequestration.
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