Role of C- Reactive Protein in Fever without Focus in Children between 1 to 36 Months of Age
Journal Title: International Journal of Health Sciences and Research - Year 2017, Vol 7, Issue 2
Abstract
Background: Fever without any source (FWS) of infection is one of the most common complaints seen in emergency departments in children <36 months of age. In spite of modern medical technologies, prevalence and cause of fever is unclear. Set of evaluation tests are available but no single test is Gold standard. Aims: Our study aimed in using CRP as a marker to differentiate contaminated vs. true positive blood culture, compare it with other diagnostic tests WBC, ANC, ESR. Methodology: A descriptive study was done with 140 specimens obtained from febrile children between 1-36 months of age. This study was carried out from 2014 to 2015, in the department of paediatrics at a medical college and hospital and tested for total WBC count, ANC, ESR and CRP. Blood culture, Urine analysis, urine culture, colony count, chest radiograph were done. CSF analysis was done for selected cases. CRP was done by slide agglutination method followed by Semi-quantitative CRP was performed. Results: Out of 140 of children, children with serious bacterial infection are 40, and children without serious bacterial infection are 100. These children were divided into with and without Serial Bacterial Infection (SBI). Results analyzed using simple statistical proportions and ROC curve. CRP had sensitivity of 77 %, specificity of 89% PPV of 74%, NPV of 91% and likelihood ratio of 9.6% in the present study. While using CRP and WBC combination, over all sensitivity increased to 57%, specificity increased to 97%, PPV increased to 86% and NPV increased to 91%. Discussion and Conclusions: Fever in children requires rapid treatment and management. So, test with adequate sensitivity and specificity to is very much essential. This study demonstrates CRP is both more sensitive and specific in distinguishing children with occult serious bacterial infection from those without bacterial illness. Our current study reveals that CRP along with WBC count concentration is better than other tests in predicting serious bacterial infection in febrile young children.
Authors and Affiliations
Dr Chitra S
Keywords
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