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C-reactive protein in the diagnosis of melioidosis

Allen C Cheng1, Matthew Obrien, Susan P Jacups

  • 1Infectious Diseases Unit, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia. allenc@menzies.edu.au

The American Journal of Tropical Medicine and Hygiene
|May 25, 2004
PubMed

Insights

C-reactive protein (CRP) is not a reliable marker for diagnosing melioidosis, a serious infection. Even in severe cases, CRP levels can be normal, making it difficult to rule out this disease in febrile patients.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Immunology

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is a serious infection.
  • Previous studies suggested C-reactive protein (CRP) as a potential diagnostic marker for melioidosis.

Purpose of the Study:

  • To evaluate the diagnostic utility of C-reactive protein (CRP) in patients with culture-confirmed melioidosis.
  • To determine the role of CRP levels in predicting melioidosis severity and mortality.

Main Methods:

  • Retrospective review of 175 patients with culture-confirmed melioidosis.
  • Analysis of admission C-reactive protein (CRP) levels in relation to disease presentation, severity, and outcomes.
  • Multivariate analysis to identify predictors of mortality.

Main Results:

  • Admission CRP levels were often normal or only mildly elevated in melioidosis patients.
  • Normal or mildly elevated CRP was observed even in cases of severe sepsis, fatal outcomes, and relapsed melioidosis.
  • Sepsis and bacteremia were stronger predictors of mortality than CRP levels.

Conclusions:

  • Admission C-reactive protein (CRP) is not a sensitive marker for diagnosing melioidosis.
  • A normal CRP level cannot exclude the possibility of acute, chronic, or relapsed melioidosis in febrile patients from endemic areas.
  • CRP levels have limited value in assessing melioidosis severity or predicting mortality.

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