Allen L Hsiao1, M Douglas Baker. 1. Division of Emergency Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA. allen.hsiao@yale.edu
Abstract
PURPOSE OF REVIEW: Evaluation of a febrile infant or child for serious bacterial infections (SBI) can be a challenging task; there is no single reliable predictor of SBI in infants. This review examines some of the recent work evaluating the usefulness of indicators for SBI, such as white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). RECENT FINDINGS: While WBC is traditionally used as an indicator of serious infection, it appears to be the least specific and sensitive test in children. CRP and PCT are the most promising, but neither is an ideal single indicator by itself, especially in infants. There has been very limited experience with PCT in this country, however. IL-6 is more useful than WBC but less accurate than either CRP or PCT. SUMMARY: Much progress has been made in recent years in finding more accurate indicators of SBI than WBC. However, while recent developments have given clinicians some new tools in evaluating febrile infants and children, it remains a formidable undertaking. In the especially vulnerable infant population, the holy grail of a single ideal SBI indicator remains elusive.
PURPOSE OF REVIEW: Evaluation of a febrile infant or child for serious bacterial infections (SBI) can be a challenging task; there is no single reliable predictor of SBI in infants. This review examines some of the recent work evaluating the usefulness of indicators for SBI, such as white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). RECENT FINDINGS: While WBC is traditionally used as an indicator of serious infection, it appears to be the least specific and sensitive test in children. CRP and PCT are the most promising, but neither is an ideal single indicator by itself, especially in infants. There has been very limited experience with PCT in this country, however. IL-6 is more useful than WBC but less accurate than either CRP or PCT. SUMMARY: Much progress has been made in recent years in finding more accurate indicators of SBI than WBC. However, while recent developments have given clinicians some new tools in evaluating febrile infants and children, it remains a formidable undertaking. In the especially vulnerable infant population, the holy grail of a single ideal SBI indicator remains elusive.
Authors: Charlotte Z Woods-Hill; Danielle W Koontz; Anne F King; Annie Voskertchian; Elizabeth A Colantuoni; Marlene R Miller; James C Fackler; Christopher P Bonafide; Aaron M Milstone; Anping Xie Journal: Pediatr Crit Care Med Date: 2020-01 Impact factor: 3.624
Authors: Karim M Mansour; Frans A Kuypers; Tammy N Wang; Annabeth M Miller; Sandra K Larkin; Claudia R Morris Journal: Am J Emerg Med Date: 2010-08-13 Impact factor: 2.469
Authors: Thor A Wagner; Courtney A Gravett; Sara Healy; Viju Soma; Janna C Patterson; Michael G Gravett; Craig E Rubens Journal: J Glob Health Date: 2011-12 Impact factor: 4.413
Authors: Ruud G Nijman; Yvonne Vergouwe; Matthew Thompson; Mirjam van Veen; Alfred H J van Meurs; Johan van der Lei; Ewout W Steyerberg; Henriette A Moll; Rianne Oostenbrink Journal: BMJ Date: 2013-04-02