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Reduced acute phase response to differentiate between viral and bacterial infections in children
Joseph Urbach1, Rivka Rotstein, Renato Fusman
1Department of Pediatrics, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel.
Insights
Children with viral infections show a reduced acute phase response compared to bacterial infections. This involves lower white blood cell counts and less cell aggregation, impacting microcirculation flow.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- The acute phase response (APR) is a systemic reaction to infection.
- Distinguishing between viral and bacterial infections in children is crucial for appropriate treatment.
Purpose of the Study:
- To document and compare the acute phase response in children with viral versus bacterial infections.
- To investigate potential diagnostic implications of differing APR levels.
Main Methods:
- Measured white blood cell count (WBCC), erythrocyte sedimentation rate (ESR), and leukocyte/erythrocyte adhesiveness/aggregation.
- Compared these markers in three groups: children with acute bacterial infection, children with viral infection, and healthy controls.
Main Results:
- Children with viral infections exhibited significantly lower WBCC, ESR, and leukocyte/erythrocyte adhesiveness/aggregation compared to those with bacterial infections.
- Specific values for viral vs. bacterial infections were: WBCC (10,800 vs. 20,000 cells/cm2), ESR (29 vs. 53 mm Hg), adhesiveness (23% vs. 41%), and aggregation (3.4 vs. 9.8 microns).
Conclusions:
- A reduced acute phase response is characteristic of acute viral infections in children.
- This finding has diagnostic value and suggests less microcirculatory impairment in viral infections due to reduced cell aggregation.
Abstract:
The objective of this study was to document the reduced acute phase response that appears in children with viral as opposed to bacterial infections. The white blood cell count (WBCC), the erythrocyte sedimentation rate (ESR), and leukocyte and erythrocyte adhesiveness/aggregation were determined in 36 children with acute bacterial infection, 29 children with viral infection, and 19 controls. A significant reduced WBCC, ESR, and leukocyte and erythrocyte adhesiveness/aggregation was noted in the children with acute viral infection as opposed to those with bacterial infection: 10,800 +/- 3600 and 20,000 +/- 10,000 cells/cm2, 29 +/- 21 and 53 +/- 35 mm Hg, 23 +/- 9 and 41 +/- 15%, and 3.4 +/- 5.1 and 9.8 +/- 13.6 microns, respectively. The results indicate that a reduced acute phase response can be observed in children with an acute viral infection. This can have diagnostic implications and pathophysiological consequences in terms of less flow impairment in the microcirculation due to less red and white blood cell aggregation.