Secretory phospholipase A2: a marker of infection in febrile children presenting to a pediatric ED.
Am J Emerg Med
; 29(9): 1163-8, 2011 Nov.
Article
em En
| MEDLINE
| ID: mdl-20708879
ABSTRACT
BACKGROUND:
Fever is a common presenting complaint to the emergency department (ED), and the evaluation of the febrile child remains a challenging task.OBJECTIVE:
The aim of this study was to examine the relationship between secretory phospholipase A2 (sPLA2) and infection in febrile children.METHODS:
A prospective convenience sample of children presenting with fever to an urban pediatric ED were studied. Blood and urine cultures, a complete blood count, and serum concentrations of sPLA2 were obtained, and patients were compared based on their final diagnosis of either a viral or bacterial infection.RESULTS:
In the 76 patients enrolled, 60 were diagnosed with a viral infection, 14 with a bacterial infection, 1 with Kawasaki disease, and 1 with acute lymphoblastic leukemia. The difference in the serum concentration of sPLA2 in patients with viral infections (22 ± 34 ng/mL) versus those with bacterial infections (190 ± 179 ng/mL) was statistically significant (P < .0001). Receiver operator characteristic curve analysis revealed that sPLA2 was more accurate at predicting bacterial infection (area under the curve = 0.89) than the total white blood cell count (area under the curve = 0.71) and that a value of more than 20 ng/mL had a sensitivity of 93%, specificity of 67%, positive predictive value of 39%, and negative predictive value of 97%.CONCLUSION:
Secretory phospholipase A2 differs significantly in children with viral versus bacterial infection and seems to be a reliable screening test for bacterial infection in febrile children.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Serviço Hospitalar de Emergência
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Fosfolipases A2 Secretórias
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Febre
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Infecções
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article