Serial serum C-reactive protein to monitor recovery from acute hematogenous osteomyelitis in children.
Serial C-reactive protein (CRP) and erythrocyte sedimentation rate determinations were compared with clinical course and outcome at 1 to 2 months in 63 children with acute hematogenous osteomyelitis. High CRP values (163 +/- 108 mg/liter) on admission began to descend after the second day of treatment. From the fourth day on higher (P = 0.03 to P = 0.0001) CRP values distinguished a complicated from an uneventful course of acute hematogenous osteomyelitis and the patients symptomatic at follow-up (P = 0.003 to P = 0.0001) from asymptomatic ones. Children who developed extensive radiographic changes had elevated CRP values for a longer time (32 +/- 13 days) than children with typical changes (11 +/- 6 days, P = 0.0001). Erythrocyte sedimentation rates did not identify the type of clinical course but higher values on Days 4 to 7 distinguished children symptomatic at follow-up (P = 0.02) from asymptomatic ones. Monitoring serial CRP values can alert the physician to complications and predict outcome earlier than clinical signs or roentgenograms.
Roine
I
I
National Children's Hospital, San José, Costa Rica.
Faingezicht
I
I
Arguedas
A
A
Herrera
J F
JF
Rodríguez
F
F
D000208:Acute Disease; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D006193:Haemophilus influenzae; D006801:Humans; D010019:Osteomyelitis / Q000097:blood / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000382:microbiology; D011859:Radiography; D013211:Staphylococcus aureus; D013297:Streptococcus pyogenes
D002097:C-Reactive Protein