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Inflammatory biomarkers to guide diagnostic and therapeutic decisions in children presenting with fever without

Giulia Trippella1, Luisa Galli2, Maurizio de Martino3

  • 1a Department of Health Science , Post-graduate School of Pediatrics, Anna Meyer Children's University Hospital, University of Florence , Florence , Italy.

Journal of Chemotherapy (Florence, Italy)
|April 6, 2018
PubMed

Insights

C-reactive protein (CRP) and procalcitonin (PCT) are effective inflammatory biomarkers for diagnosing fever in children. CRP is accessible, while PCT offers higher specificity, especially in younger children.

Area of Science:

  • Pediatric infectious diseases
  • Clinical diagnostics
  • Biomarker research

Background:

  • Fever without apparent source is common in children.
  • Accurate diagnosis is crucial for appropriate clinical decision-making.
  • Inflammatory biomarkers aid in differentiating bacterial infections.

Purpose of the Study:

  • Evaluate diagnostic performance of inflammatory biomarkers.
  • Assess biomarker utility in pediatric fever management.
  • Compare biomarkers like CRP, PCT, and Lab-score.

Main Methods:

  • Systematic review of literature (2011-2016).
  • Searched Pubmed database for relevant studies.
  • Included 13 studies analyzing various inflammatory markers.

Main Results:

  • C-reactive protein (CRP) and procalcitonin (PCT) showed best performance.
  • Optimal thresholds: CRP at 20 mg/L, PCT at 0.5 ng/mL.
  • PCT demonstrated higher specificity in younger children; CRP is more accessible.

Conclusions:

  • CRP and PCT are valuable biomarkers for pediatric fever.
  • Lab-score improves accuracy but increases costs.
  • CRP's accessibility and point-of-care availability make it a practical choice.

Keywords:
BiomarkersC-reactive proteinChildrenFever of unknown originProcalcitonin

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