C-reactive protein in early detection of bacteremic versus viral infections in immunocompetent and compromised children.
The value of quantitatively determined C-reactive protein (CRP), measured from a finger prick sample for rapid detection of septicemia, was examined in 76 blood culture-positive infections in 54 immunocompetent and 18 compromised children; 73 patients with systemic viral infections served as controls. Development of a positive CRP reaction was also studied in 40 cases of acute epiglottitis. Beyond the neonatal age, an increased CRP value (greater than or equal to 20 mg/L) was found in 60 of 64 (94%) children with a positive blood culture for bacteria or fungus. By contrast, CRP remained below this value in 56 of 73 (77%) with viral infections. The immunologic status did not influence the CRP response. However, time had a highly significant (p less than 0.001) effect on CRP; a history of 6 to 12 hours of illness was required before CRP increased above normal. We conclude that CRP is a sensitive and rapidly reacting index in bacteremic infections. However, because other factors than septicemia also increase CRP, we deem a negative CRP value most informative; if two determinations taken several hours apart are less than 20 mg/L, the patient is very unlikely to have invasive bacterial infection.
Peltola
H
H
Children's Hospital, University of Helsinki, Finland.
Jaakkola
M
M
D000293:Adolescent; D002097:C-Reactive Protein / Q000032:analysis*; D002177:Candidiasis / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004826:Epiglottitis / Q000097:blood; D006192:Haemophilus Infections / Q000097:blood; D006193:Haemophilus influenzae; D006801:Humans; D007108:Immune Tolerance; D007121:Immunocompetence; D007223:Infant; D007231:Infant, Newborn; D018805:Sepsis / Q000097:blood*; D014777:Virus Diseases / Q000097:blood*
D002097:C-Reactive Protein