Abstract
Background: Serum C-reactive protein(CRP) is a nonspecific, acute phase protein which rises in response to infection. Consequently, it is a widely used tool in investigating the febrile child with the aim of distinguishing bacterial from viral illness.
Aim: To determine the utility of serum CRP in the detection of significant bacterial infection(SBI) in children.
Methods: A retrospective chart review of children investigated for possible infection, over a six month period. Any child who had a white cell count, blood culture and CRP obtained concurrently was included. The positive and negative predictive values and risk ratio(RR) of CRP in relation to significant bacterial infection were calculated.
Results: 395 patients were included in the study. Age range 6 days to 15 years. 71 had either laboratory or radiologically proven SBI. The CRP was significantly higher in the SBI group compared to the non SBI group. A CRP of >100 is the best predictor of SBI, with a positive predictive value of 45% and a RR of 2.96(p=0.00006). Conversely, a normal CRP was found to occur in 10% of patients with SBI.
Conclusion: Serum CRP is a useful screening tool in identifying those febrile children most at risk of SBI. However, it is worth highlighting that some children with a normal CRP will also have SBI. Hence it must always be used in conjunction with a thorough clinical examination.
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McFetridge, L., Macleod, C. & Jenkins, M. 181 Serum C-Reactive Protein and The Detection of Significant Bacterial Infection In Children. Pediatr Res 56, 494 (2004). https://doi.org/10.1203/00006450-200409000-00204
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DOI: https://doi.org/10.1203/00006450-200409000-00204