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JYMS : Journal of Yeungnam Medical Science

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Cheol Hwan So 1 Article
Predictive value of C-reactive protein for the diagnosis of meningitis in febrile infants under 3 months of age in the emergency department
Tae Gyoung Lee, Seung Taek Yu, Cheol Hwan So
Yeungnam Univ J Med. 2020;37(2):106-111.   Published online January 8, 2020
DOI: https://doi.org/10.12701/yujm.2019.00402
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  • 3 Crossref
AbstractAbstract PDF
Background
Fever is a common cause of pediatric consultation in the emergency department. However, identifying the source of infection in many febrile infants is challenging because of insufficient presentation of signs and symptoms. Meningitis is a critical cause of fever in infants, and its diagnosis is confirmed invasively by lumbar puncture. This study aimed to evaluate potential laboratory markers for meningitis in febrile infants.
Methods
We retrospectively analyzed infants aged <3 months who visited the emergency department of our hospital between May 2012 and May 2017 because of fever of unknown etiology. Clinical information and laboratory data were evaluated. Receiver operating characteristic (ROC) curves were constructed.
Results
In total, 145 febrile infants aged <3 months who underwent lumbar punctures were evaluated retrospectively. The mean C-reactive protein (CRP) level was significantly higher in the meningitis group than in the non-meningitis group, whereas the mean white blood cell count or absolute neutrophil count (ANC) did not significantly differ between groups. The area under the ROC curve (AUC) for CRP was 0.779 (95% confidence interval [CI], 0.701–0.858). The AUC for the leukocyte count was 0.455 (95% CI, 0.360–0.550) and that for ANC was 0.453 (95% CI, 0.359–0.547). The CRP cut-off value of 10 mg/L was optimal for identifying possible meningitis.
Conclusion
CRP has an intrinsic predictive value for meningitis in febrile infants aged <3 months. Despite its invasiveness, a lumbar puncture may be recommended to diagnose meningitis in young, febrile infants with a CRP level >10 mg/L.

Citations

Citations to this article as recorded by  
  • Fever without a source under 3 months of age: any predictive factors of Serious Bacterial Infection?
    Rita Calejo Pereira Machado Ribeiro, Joana Raquel Pinto de Carvalho Queiros, Ana Ines Rodrigues Paiva Ferreira, Ines Isabel Aires Martins, Fabio David Monteiro Barroso
    Pediatric Oncall.2024;[Epub]     CrossRef
  • Immunologic biomarkers for bacterial meningitis
    Mina Yekani, Mohammad Yousef Memar
    Clinica Chimica Acta.2023; 548: 117470.     CrossRef
  • Febrile infants: written guidelines to reduce non-essential hospitalizations
    Ji Yoon Oh, Soo-Young Lee
    World Journal of Pediatrics.2021; 17(5): 555.     CrossRef

JYMS : Journal of Yeungnam Medical Science