Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children

Nohynek, Hanna; Valkeila, Esko; Leinonen, Marja; Eskola, Juhani

doi:10.1097/00006454-199506000-00004

Cited by 114 publications

(61 citation statements)

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“…In a recent study, the bacterial aetiology of acute lower respiratory infection was indicated by antibody assays; no cut-off values for CRP, ESR or WBC, and no combinations of them, were able to differentiate bacterial from viral cases [17]. The aetiological agent was H. influenzae, B. catarrhalis or M. pneumoniae in 31% of the cases, and S. pneumoniae in only 12%.…”

Section: Discussionmentioning

confidence: 97%

White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children

Korppi

Heiskanen‐Kosma²,

Leinonen³

1997

Eur Respir J

145

109

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White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children. M. Korppi, T. Heiskanen-Kosma, M. Leinonen. ©ERS Journals Ltd 1997. ABSTRACT: We evaluated the applicability of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC), and absolute neutrophil count (ANC), in the screening of pneumococcal (PNC) pneumonia in children.In 1981-1982, 161 children were treated for radiologically verified communityacquired pneumonia in the hospital during a period of 12 months. The Streptococcus pneumoniae aetiology of infection was studied by antigen, antibody and immune complex assays in acute and convalescent sera. In acute blood samples, CRP was measured by the immunonephelometric method, ESR by the Westergren method, WBC using an automatic cell counter, and thereafter the ANC was calculated after microscopic examination of peripheral smears.CRP and ESR were significantly higher in patients with alveolar (n=53) than in those with interstitial (n=108) pneumonia. CRP, ESR and ANC were significantly higher in PNC (n=29) than in viral (n=23) pneumonia. The values in mixed PNC and viral infections (n=17) were approximately midway between PNC and viral cases. All cases with serologic evidence of S. pneumoniae aetiology were combined (n=46) for calculation of diagnostic parameters. When a cut-off limit of 60 mg·L -1 was used, CRP had a sensitivity of 26% and a specificity of 83% in the screening of PNC pneumonia.We conclude that C-reactive protein and erythrocyte sedimentation rate have a limited capacity to differentiate between pneumococcal and nonpneumococcal pneumonia. C-reactive protein is recommended as the first-line method of screening, and the value of 60 mg·L -1 as the cut-off limit. Eur Respir J 1997; 10: 1125-1129

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Section: Discussionmentioning

confidence: 97%

White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children

Korppi

Heiskanen‐Kosma²,

Leinonen³

1997

Eur Respir J

145

109

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“…Moreover, in mucosa-limited infections (typical of most community-acquired pneumonia episodes in developed countries) WBC, CRP and ESR values tend to remain low [26]. Their potential for differentiating aetiological agents is therefore highly limited, and considerable overlapping of individual values has been reported in aetiological groups [10,11].…”

Section: Discussionmentioning

confidence: 99%

Mycoplasma pneumoniaeandChlamydia pneumoniaeinfections in children with pneumonia

Esposito¹,

Blasi²,

Bellini³

et al. 2001

Eur Respir J

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The most common clinical signs, host responses and radiographic patterns were studied in 203 Italian children hospitalized for community-acquired pneumonia in order to clarify the role of clinical and radiological characteristics in the diagnosis of Mycoplasma pneumoniae and/or Chlamydia pneumoniae infections.Antibody measurements in paired sera and polymerase chain reaction on nasopharyngeal aspirates were used to establish the diagnoses of acute M. pneumoniae and C. pneumoniae infection, and the aetiologic data were correlated with the clinical, laboratory and radiographic data obtained on admission.No significant association was observed between evidence of M. pneumoniae and/or C. pneumoniae infection and periods of episode during the year, mean age of the study subjects, individual symptoms, physical findings or laboratory test results. Furthermore, no significant correlation was observed in relation to the radiological findings and M. pneumoniae and/or C. pneumoniae infection.This study shows that neither clinical findings nor laboratory parameters distinguished Mycoplasma pneumoniae and/or Chlamydia pneumoniae infection in children with pneumonia. Radiological findings also have a limited capacity to differentiate aetiologic agents. The priorities for future research include the development of rapid, easily accessible and cost-effective diagnostic tests useful for each episode of pneumonia in children.

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“…[11][12][13] A small portion of washed sputum was homogenized and smeared on a glass slide for Gram staining, and another was cultured in sheep blood agar and horse blood chocolate agar medium and incubated at 37°C in an atmosphere containing 5% CO 2 for 20-24 h. All Gram stain smears were judged to be valid according to Murray's methods and Geckler's classification, based on the number of leucocytes or alveolar macrophages and squamous or ciliated epithelial cells in a low-power microscopic field (100ϫ). 1,5 Smears with Geckler's groups of 4-5, which contained more than 25 leucocytes or macrophages and fewer than 25 squamous or ciliated epithelial cells in a low-power microscopic field (100ϫ) were considered to be satisfactory or adequate. On Gram staining slides, pathogenic bacteria were estimated on the basis of Gram stain reaction and typical morphologies.…”

Section: Methodsmentioning

confidence: 99%

Value of washed sputum gram stain smear and culture for management of lower respiratory tract infections in children

Cao

Ishiwada

Takeda

et al. 2004

Journal of Infection and Chemotherapy

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Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children

Cited by 114 publications

References 0 publications

White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children

White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children

Mycoplasma pneumoniaeandChlamydia pneumoniaeinfections in children with pneumonia

Value of washed sputum gram stain smear and culture for management of lower respiratory tract infections in children

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