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Thrombocytosis as a Predictor of Serious Bacterial Infection in Febrile Infants

Deepak Mishra1, Amit Kumar Das2, Ram Hari Chapagain1

  • 1Department of Paediatrics, Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal.

Journal of Nepal Health Research Council
|February 12, 2019
PubMed

Insights

Thrombocytosis is common in febrile infants with serious bacterial infections (SBI), but it has moderate diagnostic ability alone. Combining thrombocytosis with other markers like C-reactive protein improves early SBI prediction in infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Diagnostic Markers

Background:

  • Febrile infants under 90 days old often have viral infections, but a significant minority develop serious bacterial infections (SBI).
  • Accurate, rapid, and inexpensive diagnostic markers are crucial for managing febrile infants.
  • This study investigated thrombocytosis as a predictor of SBI in young febrile infants.

Purpose of the Study:

  • To assess the role of thrombocytosis in predicting serious bacterial infection (SBI) in febrile infants aged 29-90 days.
  • To evaluate the diagnostic accuracy of thrombocytosis, alone and in combination with other markers.
  • To determine the utility of thrombocytosis in early identification of infants at risk for SBI.

Main Methods:

  • A hospital-based, cross-sectional observational study was conducted.
  • 76 febrile infants aged 29-90 days were enrolled.
  • Data on thrombocytosis, C-reactive protein, pyuria, and leukocytosis were collected and analyzed.

Main Results:

  • Serious bacterial infection (SBI) incidence was 56.6%.
  • Thrombocytosis, elevated C-reactive protein, and pyuria were significantly higher in SBI cases (p<0.05).
  • Elevated C-reactive protein showed the highest sensitivity (81.4%) and area under the curve (AUC: 0.846) for identifying SBI. Thrombocytosis alone had moderate ability (AUC: 0.722).

Conclusions:

  • Thrombocytosis is a frequent finding in infants with SBI but has moderate predictive ability alone.
  • Combining thrombocytosis with elevated C-reactive protein, leukocytosis, and pyuria significantly enhances sensitivity for diagnosing SBI.
  • This combination of markers may aid in the early prediction of SBI risk in young febrile infants.
Abstract

Keywords:
Febrile young infants; serious bacterial infection; thrombocytosis.

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