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Biochemical tests cannot differentiate between tonsillar and middle ear-derived infections

Ann Marlene Gram Christensen1, Martin Glymer Kirkegaard, Thomas Skov Randrup

  • 1Øre-næse-halsafdelingen, Kirurgisk Afsnit, Aarhus Universitetshospital, Bygning 10, Nørrebrogade 44, 8000 Aarhus C, Denmark. ann.mgc@hotmail.com

Danish Medical Journal
|May 16, 2013
PubMed
Abstract

Insights

C-reactive protein (CRP) and absolute neutrophil count (ANC) levels correlate with tonsillar infection severity. However, these infection markers, along with white blood cell count (WBC), showed limited use in differentiating middle ear infections or for differential diagnostics.

Area of Science:

  • Otolaryngology
  • Infectious Disease
  • Clinical Diagnostics

Background:

  • Infection markers like CRP, WBC, and ANC are valuable in diagnosing ear, nose, and throat (ENT) infections.
  • The study investigates the diagnostic utility of these markers in relation to the severity of middle ear and tonsillar infections.

Purpose of the Study:

  • To evaluate the differential diagnostic value of C-reactive protein (CRP), white blood cell count (WBC), and absolute neutrophil count (ANC).
  • To assess the relationship between these infection markers and the severity of middle ear and tonsillar infections within ENT patients.

Main Methods:

  • Retrospective study of 1,773 patients admitted to the ENT Department between 2001 and 2008.
  • Inclusion criteria involved diagnoses such as acute otitis media, mastoiditis, acute tonsillitis, and various abscesses.
  • Analysis focused on CRP, WBC, and ANC levels in relation to infection type and severity.

Main Results:

  • Significant differences in CRP, WBC, and ANC levels were observed among tonsillar infection subgroups (p < 0.001).
  • No significant differences in these markers were found for middle ear infections (p > 0.46).
  • Sensitivities and specificities for differential diagnostics were low; CRP levels above reference were more frequent than WBC and ANC.

Conclusions:

  • CRP and ANC levels correlate with the severity of tonsillar infections but not middle ear infections.
  • The studied infection markers (CRP, WBC, ANC) demonstrated limited utility for differential diagnosis in these ENT conditions.

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