Aim:

To assess the utility of serum C-reactive protein (CRP) and Procalcitonin (PCT) as a screening method for occult bacterial infection (OBI) in 3-36 month old children.

Materials and Methods:

Febrile children, who were admitted to emergency department with ages ranging from 3 to 36 months, temperatures > 38.3°C, and clinically undetectable source of fever, were enrolled in this study. Sex, age, degree of fever, Yale Observation Scale (YOS) score, antibiotic treatment and hospitalization were recorded at the time of the initial evaluation. Rou-tine urine analysis, white blood cell count (WBC) count, CRP and PCT determination tests were performed at the initial evaluation. Viral serology was done and patients having specific IgM posi-tivity during the acute phase and/or a four-fold increase in specific IgG titer during convalescence phase were considered to be positive. A chest radiograph, blood culture and urine cultures were taken from all patients. The patients were divided into two groups: OBI group and viral infection group. These two groups were compared for each predictor.

Results:

There were 10 patients with OBI, six with urinary tract infection two with pneumonia, one with bacterial meningitis and one with bacteremia and 16 patients with viral infection, (five Adenovirus, five Respiratory syncytial virus, four Enterovirus, one Parainfluenza type 1, one Epste-in-Barr virus. Regarding the CRP values, there was no statistical difference between OBI and viral infection groups (respectively, median 44.84 mg/L and 23.3 mg/L, p=0.097), but PCT values were significantly higher in OBI group (respectively, median 2.38 ng/mL and 0.28 ng/mL, p=0.014).

Conclusion:

This study showed that PCT is superior than CRP in detecting OBI and could be used for screening purposes in pediatric emergency departments while elevated levels might be found in some viral infections.

Keywords: Occult bacterial infection, C-reactive protein, Procalcitonin