scholarly journals Biomarkers: A Definite Plus in Pneumonia

2009 ◽  
Vol 2009 ◽  
pp. 1-9 ◽  
Author(s):  
Hanssa Summah ◽  
Jie-Ming Qu
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Proinflammatory Cytokines ◽  
Leukocyte Count ◽  
Diagnostic Biomarker ◽  
C Reactive Protein ◽  
Ongoing Research ◽  
Easy Task ◽  
Reactive Protein ◽  
The Past

During the past few years, biomarkers have emerged as an indispensible tool in the diagnosis of pneumonia. To find an ideal diagnostic biomarker for pneumonia is not an easy task. Not only should it allow an early diagnosis of the condition, but it should also allow differential diagnosis from other noninfectious conditions. Ongoing research is being done in this field so as to put an array of biomarkers at the disposal of doctors to improve the diagnosis of pneumonia when patients present to them with cough or nonspecific symptoms which could easily be misinterpreted as symptoms of other conditions. Procalcitonin and soluble triggering receptor expressed on myeloid cells-1 have emerged as reliable diagnostic markers in pneumonia, and are better when compared to other markers, namely, C-reactive protein, leukocyte count, and proinflammatory cytokines. Many other biomarkers are being studied for their probable use in diagnosing pneumonia but have yet to prove their benefit.

scholarly journals Transient leukocytosis in Emergency Room: an overlooked issue

2017 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Giampiera Bertolino ◽  
Federica Quaglia ◽  
Luigia Scudeller ◽  
Iride Ceresa ◽  
Carlo L. Balduini
Keyword(s):  
Differential Diagnosis ◽  
Emergency Room ◽  
Blood Cells ◽  
Leukocyte Count ◽  
White Blood Cells ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Reliable Marker ◽  
Wbc Count ◽  
Clinical Records

Leukocytosis is regarded as a reliable marker of a serious disorder requiring hospitalization. However, leukocytosis often disappears once the patient is admitted to a medical ward; differential diagnosis of leukocytosis is often overlooked in the busy Emergency Room (ER) routine. We retrospectively evaluated the clinical records of 565 consecutive patients admitted to the Department of Internal Medicine (DIM) after examination in ER. Mean leukocyte count was 11.4×109/L in ER and 10.1×109/L in DIM (P<0.001). Leukocytosis was found in 53.1% of patients in ER, but in 33% of these it was no longer evident on the following day, unrelated to baseline white blood cells (WBC) count, age, sex, diagnosis, C-reactive protein level and early antibiotic treatment. A reduction in WBC count larger than 40% from baseline occurred in 13.6% of all subjects, and in 31.7% of those with transient leukocytosis. Leukocytosis in ER is frequent, but it is often transient and not associated with an infectious cause. Other causes, including psychological stress caused by the ER access itself, should be considered in the differential diagnosis.

Early Diagnosis of Neonatal Sepsis

PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 1036-1041 ◽  
Author(s):  
Alistair G. S. Philip ◽  
Jean R. Hewitt
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Leukocyte Count ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Valuable Adjunct ◽  
Laboratory Facilities ◽  
Rapid Tests ◽  
Probable Infection

To better define the need for antibiotic therapy, several tests recommended as helpful in diagnosing neonatal sepsis were evaluated in 376 neonates during the first week after birth. The five most useful tests (with definitions of abnormality) were: band/total neutrophils ([unknown]0.2); leukocyte count (<5,000/cu mm); latex-C-reactive protein (positive >0.8 mg/100 ml); ESR ([unknown]15 mm for the first hour); and latex haptoglobin (positive >25 mg/100 ml). When these five tests were applied early (at the time infection was suspected and blood culture sent), 28 of 30 cases (93%) subsequently proven to have infection had two or more abnormal tests. This compares with only 24 of 320 babies (8%) with no subsequently documented evidence of infection. Of all babies who had two or more tests positive (n = 71), 39% had proven sepsis, and an additional 23% had "very probable" infection. The combination of leukopenia and an elevated band/total neutrophil ratio seems to be particularly predictive of sepsis (13 of 17 babies with this combination had proven sepsis). When less than two tests were positive, the probability that sepsis was not present was 99%. These simple, rapid tests require no special laboratory facilities and provide a valuable adjunct in the early detection of the neonate with sepsis.

Utility of Blood Markers in Early Prediction of Bacteraemia in Acute Febrile Paediatric Patients – An Observational Cohort Study in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (28) ◽  
pp. 2526-2531
Author(s):  
Rabindra Bhunia ◽  
Bindu T. Nair ◽  
Vandana Negi
Keyword(s):  
Tertiary Care Hospital ◽  
Leukocyte Count ◽  
Tertiary Care ◽  
North India ◽  
Total Leukocyte Count ◽  
Care Hospital ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Observational Cohort

BACKGROUND Bacteraemia is a common cause of children presenting to the paediatric emergency with acute febrile illness. Blood cultures remain the gold standard for detection of bacteraemia but the positivity is low and also takes time to show positive results. A rapid and reliable biomarker like procalcitonin (PCT), C-reactive protein (CRP), total leucocyte count (TLC), and neutrophil-lymphocyte count ratio (NLCR) can be used to identify febrile children with greater risk for bacteraemia or serious bacterial infections. This would be very helpful to start early treatment of bacteraemia with antibiotics. METHODS The study was an observational cohort study conducted in the Department of Paediatrics of a tertiary care hospital in North India in children between age group 6 months to 12 years presenting with fever of > 100.4° F for 2 - 7 days. Blood samples were sent for PCT, CRP, TLC, NLCR and blood cultures. RESULTS The most sensitive biomarker was total leukocyte count (47.36 %) followed by the neutrophil percentage (26.32 %), C-reactive protein (21.05 %), and procalcitonin (15.79 %). The most specific biomarker was procalcitonin (75.14 %) followed by C-reactive protein (58.56 %), neutrophil percentage (22.65 %) and total leukocyte count (11.05 %). The only biomarker that was statistically significant between the bacteraemia and non-bacteraemia group in the present study was total leukocyte count (P – value < 0.05). CONCLUSIONS The sensitivity and specificity of each single biomarker is low and hence these cannot be used singly to predict bacteraemia. There should be a combination of biomarkers with adequate sensitivity and specificity that can be used to create an algorithm to aid in diagnosis and prognostication. KEYWORDS Procalcitonin, C-Reactive Protein, Blood Culture, Acute Febrile Patient

Role of C-reactive protein, D-dimer, and fibrinogen levels in the differential diagnosis of central and peripheral vertigo

2007 ◽  
Vol 24 (5) ◽  
pp. 1068-1077 ◽  
Author(s):  
Emine Akinci ◽  
Gulbin Aygencel ◽  
Ayfer Keles ◽  
Ahmet Demircan ◽  
Fikret Bildik
Keyword(s):  
Differential Diagnosis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Peripheral Vertigo ◽  
D Dimer

scholarly journals Role of Serial C-reactive Protein (CRP) in Relation to Total Leucocyte Count, Platelet Count & Blood Culture for early Diagnosis of Neonatal Septicemia in Developing Countries

2015 ◽  
Vol 32 (2) ◽  
pp. 61-65
Author(s):  
Chiranjib Barua ◽  
Md Nurul Anwar ◽  
Md Shahidullah ◽  
Shahadat Hossain ◽  
Sharmila Barua ◽  
...  
Keyword(s):  
Developing Countries ◽  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Leucocyte Count ◽  
Control Group ◽  
Total Leucocyte Count ◽  
C Reactive Protein ◽  
Neonatal Septicemia ◽  
Reactive Protein

Neonatal septicemia is a clinical syndrome of systemic illness accompanied by bacteremia occuring in the first 28 days of life. Neonatal septicemia is one of the major causes of neonatal death in developing countries. Early diagnosis and treatment can prevent neonatal mortality and morbidity. The present study includes: 1) usefulness of CRP (C-reactive protein), Total Leucocyte Count, Platelet Count and Blood Culture in early diagnosis of Neonatal Sepsis, 2) significance of serial CRP in diagnosis of neonatal sepsis. 3) the prognostic value of CRP in neonatal sepsis. This is a prospective study done in neonatal ward, Chittagong Medical College Hospital and carried out from January 2008 to January 2011. Sample size was 300. One hundred fifty neonates with suspected sepsis as cases and 150 healthy babies as control were enrolled in this study. Seventy two percent of cases neonates were preterm and low birth weight. Common risk factors for neonatal septicemia which were identified in this study; preterm (72%), low birth weight (72%), premature rupture membrane (60%), chorioamnionitis (26%) and maternal urinary tract infection (16%) . Out of 150 cases of suspected neonatal sepsis total 80.7%% had raised CRP, in initial sample 70.39% were CRP positive and in 2nd sample additional 9.31% case were CRP positive . In control group 91% were CRP negative. CRP was positive in 100% of culture proven sepsis. Sensitivity of CRP was 80.67% and specificity of CRP was 76.44%. Leucocytosis was observed in 7% of cases and leucopenia was found in 11% of cases. In 82 % cases leucocyte count was found normal. In control group, 95% had normal leucocyte count and 5% had leucocytosis but no leucopenia. Sensitivity of leucocyte count was 18% and specificity was 20.68%. Thrombocytopenia was found in 28% of case group. Out of 150 cases only 15.33% yielded growth of organisms in blood culture. Klebsiella was the most common pathogen isolated which was followed by E.coli and Strph. aureus. Sensitivity of blood culture was 15.33% and specificity was 100% Therefore serial CRP can be taken as alternative method for diagnosis of neonatal sepsis specially in developing countries where blood culture is not readily available.J Bangladesh Coll Phys Surg 2014; 32: 61-65

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