Fever and laboratory profiles as predictors of serious bacterial infection in children

Abstract

Background There is a debate on the use of high fever \\lith other morbidities to predict serious bacterial infection (SBI). Bacterial infection occurs in 3􀁉15% of children with fever of 2: 39°C. Various laboratory parameters including increased C􀁉reactive protein (CRP) levels, leukocyte counts, and absolute neutrophil counts (AN C) have been studied for their usefulness in predicting the occurrence of SBI, but with varied results. The ability to discriminate whether a patient has a SBI can lead to improved patient management. Objective To evaluate fever of 2: 39°C, leukocyte counts of 2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL as predictors of SBI in children aged 1 month􀁉 18 years. Methods A case􀁉controlled study was conducted by collecting data from medical records at Sanglah Hospital, Denpasar. Subjects in the case group were diagnosed \\lith SBls (bacterial meningitis, bacterial pneumonia, bacteremia or sepsis, urinary tract infections, or bacterial gastroenteritis), and subjects in the control group non serious bacterial infections (non􀁉SBI). Data was analyzed using bivariate and multivariate methods \\lith 95% confidence intervals and a statistical significance value ofP <0.05. Results Sixty subjects were studied, \\lith 30 subjects in the case group and 30 in the control group. Baseline characteristics of subjects were similar between the two groups. Fever and CRP were predictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P 􀀁 0.009; and OR 6.20 (95% CI 1.58 to 24.24), P 􀀁 0.012, respectively]. Conclusion Fever 2: 39°C and CRP 2: 10 mgiL were significant predictors of serious bacterial infections in children. [Paediatr rndones, 2012;52:313-6].

Keywords

• serious bacterial infection
• fever
• leukocytes
• neutrophil
• C-reactive protein
• children