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.
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.