Financial support: Markus Pääkkönen has received a grant from the Foundation of Pediatric Research, Finland.
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Original Article
C-reactive protein versus erythrocyte sedimentation rate, white blood cell count and alkaline phosphatase in diagnosing bacteraemia in bone and joint infections
Article first published online: 26 FEB 2013
DOI: 10.1111/jpc.12122
© 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Additional Information
How to Cite
Pääkkönen, M., Kallio, M. J., Kallio, P. E. and Peltola, H. (2013), C-reactive protein versus erythrocyte sedimentation rate, white blood cell count and alkaline phosphatase in diagnosing bacteraemia in bone and joint infections. Journal of Paediatrics and Child Health, 49: E189–E192. doi: 10.1111/jpc.12122
Declaration of conflict of interest: There were no competing interests identified in the data collection or writing of this manuscript
Publication History
- Issue published online: 10 MAR 2013
- Article first published online: 26 FEB 2013
- Manuscript Accepted: 18 JUN 2012
- Abstract
- Article
- References
- Cited By
Keywords:
- bacteraemia;
- CRP;
- ESR;
- osteomyelitis;
- septic arthritis;
- sepsis
Aim
Bacteraemia is common in childhood acute bone and joint infections and demands urgent treatment. Blood C-reactive protein (CRP), erythrocyte sedimentation rate and white blood cell count (WBC) are well known and established markers in these infections. Instead, no information is available on serum alkaline phosphatase whose concentration is known to increase in septic conditions.
Methods
In our large prospective treatment trial comprising of 265 children with acute culture-positive bone or joint infection, all these laboratory indices were monitored on admission to hospital. The predictive value to detect bacteraemia was assessed for each of these four indices.
Results
In all, 59% of the patients showed bacteraemia. CRP was significantly (P < 0.05) higher among bacteraemic patients, whereas erythrocyte sedimentation rate, white blood cell count and alkaline phosphatase were not. The area under receiver operator characteristic curve for CRP was 0.588 (CI95% 0.524–0.649) and the significance level P (Area = 0.5) was <0.05.
Conclusion
None of the markers could reliably diagnose bacteraemia. CRP alone was significantly higher among bacteraemic patients.