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C-reactive protein as an indicator of infection in the immunosuppressed child
Insights
Serial C-reactive protein (CRP) measurements help monitor infections in children with cancer. Elevated CRP indicates bacterial sepsis, guiding antibiotic therapy and assessing treatment effectiveness.
Area of Science:
- Pediatric Oncology
- Clinical Chemistry
- Infectious Diseases
Background:
- Children with malignant diseases are often immunocompromised, increasing susceptibility to infections.
- Distinguishing infection from disease progression or treatment side effects can be challenging.
Purpose of the Study:
- To evaluate the utility of serial C-reactive protein (CRP) measurements in detecting and monitoring infections in pediatric cancer patients.
- To assess CRP's role in guiding antibiotic therapy and evaluating treatment efficacy.
Main Methods:
- Prospective study of 50 children with malignant disease.
- Measurement of C-reactive protein (CRP) concentrations.
- Correlation of CRP levels with clinical signs of infection, bacterial cultures, and antibiotic treatment.
Main Results:
- No significant CRP increase was observed in children with active disease but without infection, or during cytostatic therapy.
- Bacteriologically proven or clinically suspected sepsis cases showed CRP levels exceeding 100 mg/l (normal <5 mg/l).
- Effective antibiotic therapy led to a prompt decrease in CRP; viral infections caused a smaller CRP elevation.
Conclusions:
- Serial CRP measurements are valuable for monitoring infections in immunosuppressed children with cancer.
- CRP aids in identifying patients requiring antibiotic therapy and assessing the effectiveness of chosen treatments.
Abstract:
C-reactive protein (CRP) concentrations were determined in a prospective fashion in 50 children with malignant disease. In 35 children with active and aggressive disease, but without signs of infection, no significant increase in CRP was detected. Neither did aggressive cytostatic therapy (70 courses) in non-infected children result in an increase. In bacteriologically proven, and in clinical sepsis-suspected cases, CRP values increased in all cases to levels above 100 mg/l (normal values less than 5 mg/l). Effective antibiotic therapy resulted in a prompt decline in CRP. Viral infections resulted in a much smaller increase. We conclude that serial measurements of CRP in these immunosuppressed children are of great help in monitoring infections and defining the group that needs antibiotic therapy. The measurement is also a good indicator of the effectiveness of the antibiotic therapy chosen.