BACKGROUND: Fever is a common presenting complaint to the emergency department (ED), and the evaluation of the febrile child remains a challenging task. OBJECTIVE: The aim of this study was to examine the relationship between secretory phospholipase A2 (sPLA2) and infection in febrile children. METHODS: A prospective convenience sample of children presenting with fever to an urban pediatric ED were studied. Blood and urine cultures, a complete blood count, and serum concentrations of sPLA2 were obtained, and patients were compared based on their final diagnosis of either a viral or bacterial infection. RESULTS: In the 76 patients enrolled, 60 were diagnosed with a viral infection, 14 with a bacterial infection, 1 with Kawasaki disease, and 1 with acute lymphoblastic leukemia. The difference in the serum concentration of sPLA2 in patients with viral infections (22 ± 34 ng/mL) versus those with bacterial infections (190 ± 179 ng/mL) was statistically significant (P < .0001). Receiver operator characteristic curve analysis revealed that sPLA2 was more accurate at predicting bacterial infection (area under the curve = 0.89) than the total white blood cell count (area under the curve = 0.71) and that a value of more than 20 ng/mL had a sensitivity of 93%, specificity of 67%, positive predictive value of 39%, and negative predictive value of 97%. CONCLUSION: Secretory phospholipase A2 differs significantly in children with viral versus bacterial infection and seems to be a reliable screening test for bacterial infection in febrile children.
BACKGROUND:Fever is a common presenting complaint to the emergency department (ED), and the evaluation of the febrile child remains a challenging task. OBJECTIVE: The aim of this study was to examine the relationship between secretory phospholipase A2 (sPLA2) and infection in febrile children. METHODS: A prospective convenience sample of children presenting with fever to an urban pediatric ED were studied. Blood and urine cultures, a complete blood count, and serum concentrations of sPLA2 were obtained, and patients were compared based on their final diagnosis of either a viral or bacterial infection. RESULTS: In the 76 patients enrolled, 60 were diagnosed with a viral infection, 14 with a bacterial infection, 1 with Kawasaki disease, and 1 with acute lymphoblastic leukemia. The difference in the serum concentration of sPLA2 in patients with viral infections (22 ± 34 ng/mL) versus those with bacterial infections (190 ± 179 ng/mL) was statistically significant (P < .0001). Receiver operator characteristic curve analysis revealed that sPLA2 was more accurate at predicting bacterial infection (area under the curve = 0.89) than the total white blood cell count (area under the curve = 0.71) and that a value of more than 20 ng/mL had a sensitivity of 93%, specificity of 67%, positive predictive value of 39%, and negative predictive value of 97%. CONCLUSION:Secretory phospholipase A2 differs significantly in children with viral versus bacterial infection and seems to be a reliable screening test for bacterial infection in febrile children.
Authors: Cynthia G Whitney; Monica M Farley; James Hadler; Lee H Harrison; Nancy M Bennett; Ruth Lynfield; Arthur Reingold; Paul R Cieslak; Tamara Pilishvili; Delois Jackson; Richard R Facklam; James H Jorgensen; Anne Schuchat Journal: N Engl J Med Date: 2003-05-01 Impact factor: 91.245
Authors: Sheldon L Kaplan; Edward O Mason; Ellen R Wald; Gordon E Schutze; John S Bradley; Tina Q Tan; Jill A Hoffman; Laurence B Givner; Ram Yogev; William J Barson Journal: Pediatrics Date: 2004-03 Impact factor: 7.124
Authors: Elena Berg; Janel Paukovits; Jennifer Axelband; Jonathan Trager; Dina Ryan; Kathleen Cichonski; Mark Kopnitsky; Daniel Zweitzig; Rebecca Jeanmonod Journal: J Emerg Trauma Shock Date: 2018 Apr-Jun
Authors: Frans A Kuypers; Christina A Rostad; Evan J Anderson; Ann Chahroudi; Preeti Jaggi; Jens Wrammert; Grace Mantus; Rajit Basu; Frank Harris; Bradley Hanberry; Andres Camacho-Gonzalez; Shaminy Manoranjithan; Miriam Vos; Lou Ann Brown; Claudia R Morris Journal: Exp Biol Med (Maywood) Date: 2021-07-13