Leukocyte populations and C-reactive protein as predictors of bacterial infections in febrile outpatient children.
OBJECTIVE
Infections remain the major cause of unnecessary antibiotic use in pediatric outpatient settings. Complete blood count (CBC) is the essential test in the diagnosis of infections. C-reactive protein (CRP) is also useful for assessment of young children with serious bacterial infections. The purpose of the study was to evaluate leukocyte populations and CRP level to predict bacterial infections in febrile outpatient children.


METHODS
The values of CBC by Cell-DYN 4000 autoanalyzer and serum CRP levels were evaluated in 120 febrile patients with documented infections (n:74 bacterial, n:46 viral) and 22 healthy controls.


RESULTS
The mean CRP, neutrophil and immature granulocyte (IG) values were significantly higher in bacterial infections than in viral infections and controls (p<0.05). C-reactive protein was significantly correlated with neutrophil level in bacterial infections (r: 0.76, p<0.05). Specificity of IG was greatest at 93%, only a modest 56% for neutrophil and mild 18% for CRP, whereas 100% for combination of IG, neutrophil and CRP.


CONCLUSIONS
Acute bacterial infection seems to be very unlikely in children with normal leukocyte populations and CRP values, even if clinically signs and symptoms indicate acute bacterial infections.
Gazi University Medical School, The Pediatric Hematology Unit, Department of Pediatrics, Ankara, Turkey.
Zühre
Z
Kaya
Gazi University Medical School, The Pediatric Hematology Unit, Department of Pediatrics, Ankara, Turkey.
Aynur
A
Küçükcongar
Gazi University Medical School, The Pediatric Hematology Unit, Department of Pediatrics, Ankara, Turkey.
Doğuş
D
Vurallı
Gazi University Medical School, The Pediatric Hematology Unit, Department of Pediatrics, Ankara, Turkey.
Hamdi Cihan
HC
Emeksiz
Gazi University Medical School, The Pediatric Hematology Unit, Department of Pediatrics, Ankara, Turkey.
Türkiz
T
Gürsel
C-reactive protein; Febrile children; Leukocyte populations