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Negative C-reactive protein in children with bacterial infection
1Department of Pediatrics, Tokyo Metropolitan Bokuto General Hospital, Japan. t-kono@dokkyomed.ac.jp
Summary
Initial C-reactive protein (CRP) tests may be negative in children with bacterial infections. Pediatricians should consider serial CRP measurements if a bacterial infection is suspected, even with a normal initial result.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Biochemistry
- Diagnostic Biomarkers
Background:
- C-reactive protein (CRP) is a common biomarker for inflammation.
- Its utility in diagnosing bacterial infections in pediatric patients requires careful consideration.
Purpose of the Study:
- To assess the diagnostic value of initial C-reactive protein (CRP) levels.
- To determine if low initial CRP excludes bacterial infection in children.
Main Methods:
- Study included 11 children (3 months to 3 years) with confirmed bacterial infections.
- Initial CRP levels were measured using nephelometry at the first medical examination.
Main Results:
- Four patients had urinary tract infections, two had meningitis, two had sepsis, two had pneumonia, and one had hip arthritis.
- Initial CRP levels were < 1.0 mg/dL in all subjects, despite later significant elevations (7.6–28.5 mg/dL).
- Three patients tested negative for CRP even after 12 hours from symptom onset.
Conclusions:
- A low initial CRP level does not rule out bacterial infection in children.
- Pediatricians must consider bacterial infection possibility despite negative initial CRP.
- Serial CRP measurements are recommended for accurate diagnosis in pediatric bacterial infections.