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Evaluating Uncommon Inflammatory Markers in Common Pediatric Bacterial Infections
Christina M McKinney1, Michelle L Mitchell2, Erin Preloger3
1Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, christina.mckinney@cchmc.org.
Background:
Expected ranges for several inflammatory markers in children were poorly defined during the COVID-19 pandemic, making it difficult to distinguish common infections from multisystem inflammatory syndrome in children (MIS-C). We evaluated less commonly obtained inflammatory markers in children with common bacterial infections.
Methods:
We completed a retrospective cohort study at a tertiary children's hospital from March 2018 through April 2023 of hospitalized patients >60 days to 21 years with cellulitis, community-acquired pneumonia, or urinary tract infection.
Results:
A total of 973 patients were included (median age, 5.6 years; interquartile range, 1.9-12.2; 61% female). Most inflammatory markers were elevated across infections, whereas troponin levels remained within the reference range for all diagnoses.
Discussion:
We report values for less commonly obtained inflammatory markers in children hospitalized with common bacterial infections. Normal troponin levels may help distinguish these infections from MIS-C, which more commonly involves cardiac inflammation. Further research is needed to define clinically useful cutoff values for inflammatory markers to aid decision-making in the setting of emerging disease processes.
