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. 1986 Jan;61(1):24–29. doi: 10.1136/adc.61.1.24

C reactive protein in the evaluation of febrile illness.

A Putto, O Ruuskanen, O Meurman, H Ekblad, H Korvenranta, J Mertsola, H Peltola, H Sarkkinen, M K Viljanen, P Halonen
PMCID: PMC1777528  PMID: 3954416

Abstract

We studied prospectively 154 febrile children to determine the diagnostic value of the quantitative serum C reactive protein concentrations (CRP). Children with acute otitis media, acute tonsillitis, or treated with antibiotics during the two previous weeks and infants less than 2 months of age were excluded. Ninety seven children were from private paediatric practice and 57 were patients who had been admitted to hospital. The comparison group consisted of 75 children with confirmed bacterial infections whose CRP values were recorded retrospectively. In the study group 35 (23%) children had a confirmed viral infection, 92 (59%) had a probable viral infection as judged from the clinical picture and outcome of the illness, and 27 (18%) had a bacterial or probable bacterial infection. When the duration of the disease was more than 12 hours and the CRP value less than 20 mg/l, all children had a confirmed or probable viral infection. Nine children (one from the study group and eight from the comparison group) were found to have a septic infection and a CRP value of 20 mg/l or less. In all these cases, however, the duration of the symptoms was less than 12 hours. In addition CRP less than or equal to 20 mg/l was found in five (14%) children with urinary tract infection in the comparison group. CRP values of 20-40 mg/l were recorded in children with both viral and bacterial infections. A CRP value greater than or equal to 40 mg/l detected 79% of bacterial infections with 90% specificity. Our data show that determination of serum CRP concentrations is a valuable tool in evaluating children who have been ill for more than 12 hours.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bennish M., Beem M. O., Ormiste V. C-reactive protein and zeta sedimentation ratio as indicators of bacteremia in pediatric patients. J Pediatr. 1984 May;104(5):729–732. doi: 10.1016/s0022-3476(84)80953-1. [DOI] [PubMed] [Google Scholar]
  2. Hanson L. A., Jodal U., Sabel K. G., Wadsworth C. The diagnostic value of C-reactive protein. Pediatr Infect Dis. 1983 Mar-Apr;2(2):87–89. doi: 10.1097/00006454-198303000-00002. [DOI] [PubMed] [Google Scholar]
  3. Harmoinen A., Perko M., Grönroos P. Rapid quantitative determination of C-reactive protein using LKB 8600 Reaction Rate Analyser. Clin Chim Acta. 1981 Mar 19;111(1):117–120. doi: 10.1016/0009-8981(81)90430-7. [DOI] [PubMed] [Google Scholar]
  4. Jodal U., Lindberg U., Lincoln K. Level diagnosis of symptomatic urinary tract infections in childhood. Acta Paediatr Scand. 1975 Mar;64(2):201–208. doi: 10.1111/j.1651-2227.1975.tb03822.x. [DOI] [PubMed] [Google Scholar]
  5. Kushner I., Broder M. L., Karp D. Control of the acute phase response. Serum C-reactive protein kinetics after acute myocardial infarction. J Clin Invest. 1978 Feb;61(2):235–242. doi: 10.1172/JCI108932. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. McCabe R. E., Remington J. S. C-reactive protein in patients with bacteremia. J Clin Microbiol. 1984 Sep;20(3):317–319. doi: 10.1128/jcm.20.3.317-319.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. McCarthy P. L., Jekel J. F., Dolan T. F., Jr Comparison of acute-phase reactants in pediatric patients with fever. Pediatrics. 1978 Nov;62(5):716–720. [PubMed] [Google Scholar]
  8. McCarthy P. L., Jekel J. F., Dolan T. F., Jr Temperature greater than or equal to 40 C in children less than 24 months of age: a prospective study. Pediatrics. 1977 May;59(5):663–668. [PubMed] [Google Scholar]
  9. Peltola H. O. C-reactive protein for rapid monitoring of infections of the central nervous system. Lancet. 1982 May 1;1(8279):980–982. doi: 10.1016/s0140-6736(82)91989-4. [DOI] [PubMed] [Google Scholar]
  10. Peltola H. C-reactive protein in rapid differentiation of acute epiglottitis from spasmodic croup and acute laryngotracheitis: a preliminary report. J Pediatr. 1983 May;102(5):713–715. doi: 10.1016/s0022-3476(83)80240-6. [DOI] [PubMed] [Google Scholar]
  11. Peltola H., Holmberg C. Rapidity of C-reactive protein in detecting potential septicemia. Pediatr Infect Dis. 1983 Sep-Oct;2(5):374–376. doi: 10.1097/00006454-198309000-00009. [DOI] [PubMed] [Google Scholar]
  12. Peltola H., Luhtala K., Valmari P. C-reactive protein as a detector of organic complications during recovery from childhood purulent meningitis. J Pediatr. 1984 Jun;104(6):869–872. doi: 10.1016/s0022-3476(84)80483-7. [DOI] [PubMed] [Google Scholar]
  13. Rasmussen N. H., Rasmussen L. N. Predictive value of white blood cell count and differential cell count to bacterial infections in children. Acta Paediatr Scand. 1982 Sep;71(5):775–778. doi: 10.1111/j.1651-2227.1982.tb09518.x. [DOI] [PubMed] [Google Scholar]
  14. Ruuskanen O., Putto A., Sarkkinen H., Meurman O., Irjala K. C-reactive protein in respiratory virus infections. J Pediatr. 1985 Jul;107(1):97–100. doi: 10.1016/s0022-3476(85)80624-7. [DOI] [PubMed] [Google Scholar]
  15. Ruuskanen O., Sarkkinen H., Meurman O., Hurme P., Rossi T., Halonen P., Hänninen P. Rapid diagnosis of adenoviral tonsillitis: a prospective clinical study. J Pediatr. 1984 May;104(5):725–728. doi: 10.1016/s0022-3476(84)80952-x. [DOI] [PubMed] [Google Scholar]
  16. Sarkkinen H. K., Halonen P. E., Arstila P. P., Salmi A. A. Detection of respiratory syncytial, parainfluenza type 2, and adenovirus antigens by radioimmunoassay and enzyme immunoassay on nasopharyngeal specimens from children with acute respiratory disease. J Clin Microbiol. 1981 Feb;13(2):258–265. doi: 10.1128/jcm.13.2.258-265.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schofield K. P., Voulgari F., Gozzard D. I., Leyland M. J., Beeching N. J., Stuart J. C-reactive protein concentration as a guide to antibiotic therapy in acute leukaemia. J Clin Pathol. 1982 Aug;35(8):866–869. doi: 10.1136/jcp.35.8.866. [DOI] [PMC free article] [PubMed] [Google Scholar]

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