A case of severe chronic neutropenia without splenomegaly is reported. The disorder was characterized by chronic fatigue and many pyogenic infections, and by a persistently low neutrophile count. The marrow was cellular, with a defect in maturation in both granulocytic and megakaryocytic series. There was no improvement on the usual types of medical therapy, and splenectomy, while it was followed by transient thrombocytosis, likewise failed to induce a remission.

It is suggested that in the consideration of therapy for severe neutropenia, a lack of splenomegaly should be considered a contraindication to splenectomy.

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