[Laboratory studies in pediatric bone and joint infections].
The diagnosis of acute osteomyelitis and septic arthritis is a clinical one. Acute-phase reactants, such as white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are useful to help the clinicians at the time of initial diagnosis. The WBC count may be normal in up to 80 % of cases and it is not a reliable indicator. The ESR is elevated in 80 % of cases. CRP is elevated more than 80 % of cases. CRP rises rapidly within 48 hours of admission and returns to normal within a week after appropriate therapy. Its rapid kinetics is useful for follow-up of the response treatment. Patients who require surgical drainage procedures have prolonged time to normalization of CRP. PCT is a useful specific marker for predicting severe infection but its sensibility to detect bone and joint infections seems to be low.
Lorrot
M
M
Service de Pédiatrie Générale Hôpital Robert Debré, 82, Boulevard Sérurier 75019 Paris, France. mathie.lorrot@rdb.aphp.fr
Fitoussi
F
F
Faye
A
A
Mariani
P
P
Job-Deslandre
C
C
Penneçot
G-F
GF
Bingen
E
E
Bourrillon
A
A
D000208:Acute Disease; D000284:Administration, Oral; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers; D001799:Blood Sedimentation; D002097:C-Reactive Protein; D002116:Calcitonin / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D010019:Osteomyelitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D011498:Protein Precursors / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein