I'm a ED physician, and this...sounds unusual. In CLL, the white count should be significantly elevated which in this case, it is not. Furthermore, the presence of smudge cells is not necessarily indicative of CLL. I be surprised if this was CLL. This is likely some sort of viral infection if I had to guess.
I just went ahead and edited. ALT, AST. Plus a couple others. Whats odd to me - a person that isnt close to a dr; her WBC seems to remain decent. And regardless if its infection or virus I would expect an increase.CLL was brought up bc of the higher absolute lympho count and the moderated smudge cell. The ER doc wrote it on discharge to pcp.