Financial support: Markus Pääkkönen has received a grant from the Foundation of Pediatric Research, Finland.
C-reactive protein versus erythrocyte sedimentation rate, white blood cell count and alkaline phosphatase in diagnosing bacteraemia in bone and joint infections
Version of Record online: 26 FEB 2013
© 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 3, pages E189–E192, March 2013
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
- Issue online: 10 MAR 2013
- Version of Record online: 26 FEB 2013
- Manuscript Accepted: 18 JUN 2012
- septic arthritis;
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.
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.
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.
None of the markers could reliably diagnose bacteraemia. CRP alone was significantly higher among bacteraemic patients.