C Reactive Protein and the diagnosis of intracranial infection
Report by Amy Au‐Yong, Medical Student
Search checked by Professor Tim Coats, Professor of Emergency Medicine
Emergency Department, Leicester Royal Infirmary
Abstract
A short cut review was carried out to determine whether measuring C Reactive Protein might help in the diagnosis of intracranial infection in a patient presenting to the Emergency department with an acute headache. 62 papers were found, but none answered the question. The clinical bottom line is that there doesn't appear to be any evidence for, or against, the use of C Reactive Protein in the diagnosis of intracranial infection in patients presenting to the Emergency department with an acute headache.
Three part question
In [adult patients presenting as an emergency with headache] does [a normal CRP measurement] [exclude a diagnosis of intracranial infection]?
Clinical scenario
A 25 year old woman presents to the emergency department with acute headache. You wonder whether a C Reactive Protein (CRP) measurement will help in excluding the diagnosis of intracranial infection.
Search strategy
Medline 1950–January 2007 using the OVID interface
[exp headache OR headache$.mp] AND [Exp C Reactive Protein OR crp.mp OR (c adj reactive adj protein).mp] LIMIT TO humans and English language
Search outcome
Altogether 62 papers were found. None were relevant.
Comment(s)
Acute headache is a common presentation to the emergency department. Intracranial infection is a rare cause of headache but if this diagnosis is missed it can be disastrous for the patient. There is no evidence for or against the use of C Reactive Protein as a diagnostic tool to rule in or rule out intracranial infection.
Clinical bottom line
There is no evidence for or against the use of C Reactive Protein as a diagnostic tool in the diagnosis of intracranial infection in patients presenting to the emergency department with headache.