Abstract
The aim of this investigation was to determine the possible value of quantitative blood cultures in the diagnosis and management of febrile children with or without focal signs of infection. The magnitude of bacteremia was determined by a recently described Quantitative Direct Plating (QDP) procedure; heparinized blood (0.5 ml each) was plated onto blood and chocolate agar plates. Data on Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis bacteremia of 79 pediatric patients, who were not on prior antibiotic therapy, was correlated with the type and severity of the disease. Regarding H. influenzae and S. pneumoniae, 23 (85%) of 27 patients with meningitis or epiglottitis had more than 100 organisms/ml of blood, in contrast to 2 (5%) of 40 patients with upper respiratory infection, otitis media, pneumonia, arthritis, or cellulitis (p<0.001). No significant difference was noted in the magnitude of bacteremia due to N. meningitidis between 12 patients with or without meningitis. The possible predictive value of the quantitation of bacteremia is illustrated by the observation of three children with seemingly mild respiratory infection and counts in excess of 100 organisms/ml who, within 20 hours, developed meningitis or epiglottitis. From these observations it is suggested that high bacterial counts in excess of 100 organisms/ml of blood should alert the physician to the existence or possible development of serious disease.
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Sullivan, T., La Scolea, L. & Neter, E. 1077 RELATIONSHIP BETWEEN THE NUMBER OF BACTERIA IN THE BLOOD OF CHILDREN AND THE CLINICAL DISEASE. Pediatr Res 15 (Suppl 4), 622 (1981). https://doi.org/10.1203/00006450-198104001-01103
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DOI: https://doi.org/10.1203/00006450-198104001-01103