[Total white blood cell count, erythrosedimentation rate and C-reactive protein for the detection of serious bacterial infections in 0- to 90-day-old infants with fever without a source]. / Leucocitos en sangre, eritrosedimentación y proteína C reactiva en pacientes de 0 a 90 días de edad con fiebre sin focalización.
An Pediatr (Barc)
; 68(2): 103-9, 2008 Feb.
Article
en Es
| MEDLINE
| ID: mdl-18341874
ABSTRACT
INTRODUCTION:
Total white blood cell count (WBC), erythrosedimentation rate (ESR) and C-reactive protein (CRP) are frequently used by primary care physicians attending infants < 90 days old with fever without localizing signs to distinguish those with a serious bacterial infection (SBI). The main objective of this study was to obtain the diagnostic values of these parameters in infants with fever. PATIENTS ANDMETHODS:
We analyzed previously healthy infants aged 0 to 90 days old and fever with no source of infection admitted to the emergency room and/or hospitalized. The main outcome measure was the presence or absence of a SBI (urinary tract infection, bacteremia, meningitis, pneumonia, enteritis) and diagnostic values of WBC, ESR and CRP.RESULTS:
A total of 103 infants met the inclusion criteria. Of these, 22 infants (21.3%) had a SBI, the most common being urinary tract infection. Absolute neutrophil count (ANC) and WBC had an area under the ROC curve (AUC) of 0.6 (95% CI 0.46-0.73) and 0.55 (95% CI 0.44-0.68) respectively. An ANC>or=10,000/microl had a sensitivity and specificity of 9% (95% CI 1-21) and 92.5% (95% CI 86-98) respectively. A WBC>or=15,000/microl had a sensitivity and specificity of 13.6% (95% CI 1-28) and 85% (95% CI 77-93) respectively. CRP showed an AUC of 0.71 (95% CI 0.55-0.86) and a best cut-off point of 2 mg/dL (sensitivity 53% [95% CI 29-76] and specificity of 85% [95% CI 75-94]). ESR>or=20 mm/hour had an AUC, sensitivity and specificity of 0.53 (95% CI 0.37-0.7), 38% (95% CI 16-62) and 75% (95% CI 65-85) respectively.CONCLUSIONS:
None of these parameters alone, commonly used by physicians, is a reliable diagnostic tool to rule out SBI in infants<90 days old with fever without source of infection.
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Banco de datos:
MEDLINE
Asunto principal:
Infecciones Bacterianas
/
Proteína C-Reactiva
/
Fiebre de Origen Desconocido
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Límite:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Idioma:
Es
Año:
2008
Tipo del documento:
Article