Emphysematous Cystitis Occurred in the Case Treated with Steroid for Autoimmune Hepatitis

Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients, which was characterized by air within the bladder wall and lumen. A 83-year-old woman was introduced to our department with fever elevation and abnormal findings of computed tomography (CT). She took orally prednisolone for autoimmune hepatitis. Pelvic CT revealed diffuse air throughout the bladder wall. Urinalysis showed combined hematuria and pyuria.Escherichia coliwas detected in blood culture. Abnormal findings of complete blood count and laboratory examination included an elevated WBC count (12,200/L), C-reactive protein (11.7 mg/dL), and creatinine (1.07 mg/dL). Cystoscopy confirmed diffuse submucosal emphysema throughout. On the basis of diagnosis with emphysematous cystitis, she was treated with antibiotics based on the results of blood culture and indwelling Foley catheter. After treatment, the improvement of inflammatory findings and submucosal emphysema on cystoscopy and CT were achieved.

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Diagnostic Significance of White Blood Cell Count and C-Reactive Protein in Neonatal Sepsis; Asella Referral Hospital, South East Ethiopia

The Open Microbiology Journal ◽

10.2174/1874285801812010209 ◽

2018 ◽

Vol 12 (1) ◽

pp. 209-217

Author(s):

Abebe Sorsa

Keyword(s):

Blood Culture ◽

Blood Cell ◽

White Blood Cell ◽

Neonatal Sepsis ◽

C Reactive Protein ◽

Diagnostic Significance ◽

Gram Negative ◽

Reactive Protein ◽

Wbc Count ◽

Sensitivity Specificity

Introduction:Nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin and tumor necrosis factor alpha, have been proposed as a potential marker for screening neonatal sepsis. In the current study, we tried to see the diagnostic significance of White Blood Cell (WBC) count and CRP in diagnostic screening of neonatal sepsis.Methods:A prospective cross-sectional study was conducted from May 2016 to April 2017 in Asella Teaching and Referral Hospital. Data were entered into EPI-INFO version 3.5.1 for cleanup and then exported to SPSS version 17 for further analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were used to assess the accuracy of CRP and WBC count taking blood culture as gold standard.Results:Data of 303 neonates with clinical sepsis were analyzed. Positive CRP and abnormal WBC were reported in 136(45%) and 99(32.7%) of study subjects respectively. Blood culture turned to be positive in 88(29.4%) of study subjects. The Sensitivity, Specificity, PPV and NPV of WBC count were 59.5 %, 79.6%, 52%, 64.5% respectively while the sensitivity, specificity, PPV and NPV of CRP were 65.6%, 78%, 42% and 91% respectively. By combining both WBC and CRP, the sensitivity, specificity, PPV and NPV improve to 78.5%, 83%, 60% and 93% respectively. CRP positivity rate was comparable across gram positive and gram negative bacteria while high WBC count were more reported among gram positive sepsis than gram negative ( OR 4.8, (95% CI 1.45-15.87, P 0.01)Conclusion:Based on this study’s finding, it can be concluded that CRP alone or in combination with WBC count showed better diagnostic accuracy in neonatal sepsis.

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C-Reactive Protein in Neonatal Sepsis

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.27.2.117 ◽

2008 ◽

Vol 27 (2) ◽

pp. 117-120 ◽

Cited By ~ 7

Author(s):

Michelle Hawk

Keyword(s):

Blood Culture ◽

Neonatal Sepsis ◽

Complete Blood Count ◽

Length Of Hospital Stay ◽

Acute Phase Reactant ◽

Definitive Diagnosis ◽

C Reactive Protein ◽

Reactive Protein ◽

High Negative Predictive Value ◽

Sepsis Marker

SEPSIS IS ONE OF THE MOST COMMON diagnostic challenges in the NICU. Currently a definitive diagnosis can be made only with the gold-standard blood culture, which is generally not available for 48 hours.1,2 Difficulty obtaining a large enough sample to detect a positive blood culture, as well as increased use of antenatal antibiotics, has complicated the ability to make a definitive diagnosis of sepsis.3 If left untreated, sepsis can increase morbidity and mortality. Therefore, many infants are treated empirically with broad-spectrum antibiotics.4,5 Two kinds of tests would be most helpful in the diagnosis of neonatal sepsis: one that quickly confirms the diagnosis and one that conclusively rules it out. In fact, a diagnostic sepsis marker with a high negative predictive value (the value representing patients without sepsis who are correctly diagnosed) might reduce the short- and long-term adverse effects of antibiotics, health care costs, and length of hospital stay.6 Despite extensive investigation no single test meets the criteria that would make it an ideal marker for the early diagnosis of sepsis in the newborn.5,7,8 Generally, screening includes a complete blood count with differential and may be accompanied by other adjunctive tests such as a C-reactive protein (CRP).9–11 This column examines CRP, an acute phase reactant (APR), as a diagnostic marker for neonatal sepsis.

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Concomitant Septic Arthritis in Crystal Monoarthritis

The Journal of Rheumatology ◽

10.3899/jrheum.110368 ◽

2011 ◽

Vol 39 (1) ◽

pp. 157-160 ◽

Cited By ~ 22

Author(s):

LITO ELECTRA PAPANICOLAS ◽

PAUL HAKENDORF ◽

DAVID LLEWELLYN GORDON

Keyword(s):

Synovial Fluid ◽

Blood Culture ◽

Septic Arthritis ◽

Gram Stain ◽

C Reactive Protein ◽

Predictive Values ◽

Reactive Protein ◽

Crystal Arthritis ◽

Clinically Significant ◽

Wbc Count

Objective.In acute monoarthritis, the presence of crystals in synovial fluid may lead to a diagnosis of crystal arthritis (CA) before septic arthritis (SA) can be excluded by culture. We aimed to identify the frequency of coexistence of CA with SA and to compare these with regard to synovial fluid microscopy, C-reactive protein (CRP), and blood culture.Methods.We examined 1612 synovial aspirates from 2004 to 2009 retrospectively. Of these, 104 patients with clinically significant SA were identified. These were compared to 295 patients with isolated CA.Results.Five percent of joints with CA had concomitant infection. A high synovial white blood cell (WBC) count and elevated CRP (> 100 mg/l) were predictive of concomitant SA with a sensitivity of 86.4%, specificity of 48.3% and 54.6%, and negative predictive values of 98.5% and 98.7%, respectively. In patients with SA who had a blood culture, 42.5% were positive with a matching organism. SA of the shoulder had a 90% rate of bacteremia.Conclusion.Crystals alone in synovial fluid from acute monoarthritis cannot exclude SA, as CA and SA frequently coexist. High WBC counts and elevated CRP are common to both SA and CA. Blood cultures should be collected and septic arthritis considered, even when crystals are present, particularly if the shoulder is affected. The exception is when Gram stain is negative and the CRP is < 100 mg/l and joint WBC count is < 10,000/μl. In these circumstances it is very unlikely that there will be concomitant SA.

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Serum C-reactive protein and WBC count in conservatively and operatively managed bacterial spondylodiscitis

Journal of Orthopaedic Surgery ◽

10.1177/2309499020968296 ◽

2020 ◽

Vol 29 (1) ◽

pp. 230949902096829

Author(s):

Christina van Gerven ◽

Kevin Eid ◽

Tobias Krüger ◽

Michael Fell ◽

Daniel Kendoff ◽

...

Keyword(s):

Antibiotic Treatment ◽

Serum Levels ◽

Blood Chemistry ◽

Nonoperative Treatment ◽

C Reactive Protein ◽

Disc Disease ◽

Reactive Protein ◽

Postoperative Serum ◽

Wbc Count ◽

And Control

Purpose: C-reactive protein (CRP) and white blood cell (WBC) count are routine blood chemistry parameters in monitoring infection. Little is known about the natural history of their serum levels in conservative and operative spondylodiscitis treatment. Methods: Pre- and postoperative serum levels of CRP and WBC count in 145 patients with spondylodiscitis were retrospectively assessed. One hundred and four patients were treated by debridement, spondylodesis, and an antibiotic regime, 41 only with a brace and antibiotics. The results of the surgical group were compared to 156 patients fused for degenerative disc disease (DDD). Results: Surgery had a significant effect on peak postoperative CRP levels. In surgically managed patients, CRP peaked at 2–3 days after surgery (spondylodiscitis: pre-OP: 90 mg/dl vs. post-OP days 2–3: 146 mg/dl; DDD: 9 mg/dl vs. 141 mg/dl; p < 0.001), followed by a sharp decline. Although values were higher for spondylodiscitis patients, dynamics of CRP values were similar in both groups. Nonoperative treatment showed a slower decline. Surgically managed spondylodiscitis showed a higher success rate in identifying bacteria. Specific antibiotic treatment led to a more predictable decline of CRP values. WBC did not show an interpretable profile. Conclusion: CRP is a predictable serum parameter in patients with spondylodiscitis. WBC count is unspecific. Initial CRP increase after surgery is of little value in monitoring infection. A preoperative CRP value, and control once during the first 3 days after surgery is sufficient. Closer monitoring should then be continued. Should a decline not be observed, therapy needs to be scrutinized, antibiotic treatment reassessed, and concomitant infection contemplated.

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Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00074-y ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Ademola Olusegun Talabi ◽

Tewogbade Adeoye Adedeji ◽

Oludayo Adedapo Sowande ◽

Olusanya Adejuyigbe

Keyword(s):

Acute Appendicitis ◽

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

C Reactive Protein ◽

Blood Cell Count ◽

Alvarado Score ◽

Reactive Protein ◽

Wbc Count

Abstract Background The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis. Results The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001. Conclusion Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.

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The prognostic efficacy of beta2-microglobulin in acute pulmonary embolism

Acute Medicine Journal ◽

10.52964/amja.0655 ◽

2017 ◽

Vol 16 (2) ◽

pp. 52-59

Author(s):

Sotirios Kakavas ◽

◽

Aggeliki Papanikolaou ◽

Evangelos Balis ◽

Evgenios Metaxas ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

C Reactive Protein ◽

Reactive Protein ◽

Risk Of Death ◽

Increased Risk ◽

Preliminary Study ◽

Wbc Count ◽

A Prospective Study ◽

Acute Pe

Our aim was to prospectively assess the prognostic value of beta2- microglobulin (b2-M) in patients with acute pulmonary embolism (PE). We conducted a prospective study of 109 patients admitted in a pulmonary clinic due to acute PE. A panel of inflammatory markers including b2-M white blood cell (WBC) count and C-reactive protein (CRP) was determined for each patient. In this preliminary study, baseline b2-M levels significantly correlated with the impairment of oxygenation and with all the parameters that are used for the early risk stratification of patients. In multivariate analysis, patients’ age and baseline b2-M levels were significantly associated with an increased risk of death. These findings require further prospective validation.

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Abstract 35: Common Variants in the CRP Promoter are Associated with a High C-reactive Protein Level in Kawasaki Disease

Circulation ◽

10.1161/circ.131.suppl_2.35 ◽

2015 ◽

Vol 131 (suppl_2) ◽

Author(s):

Jae-Jung Kim ◽

Sin Weon Yun ◽

Jeong Jin Yu ◽

Kyung Lim Yoon ◽

Kyung-Yil Lee ◽

...

Keyword(s):

Kawasaki Disease ◽

Phenotypic Variation ◽

Genome Wide Association Study ◽

Replication Study ◽

Common Variants ◽

C Reactive Protein ◽

Reactive Protein ◽

A Genome ◽

Wbc Count ◽

Stage 1

Kawasaki disease (KD) is an acute self-limiting form of vasculitis that afflicts infants and children and manifests as fever and signs of mucocutaneous inflammation. Children with KD show various laboratory inflammatory abnormalities, such as elevations in their white blood cell (WBC) count, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR). We here performed a genome-wide association study (GWAS) of 178 KD patients to identify the genetic loci that influence 10 important KD laboratory markers: WBC count, neutrophil count, platelet count, CRP, ESR, hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, and total protein. A total of 165 loci passed our arbitrary stage 1 threshold for replication ( p < 1 * 10 -5 ). Of these, only 2 SNPs (rs12068753 and rs4786091) demonstrated a significant association with the CRP level in replication study of 473 KD patients ( p < 0.05). The SNP located at the CRP locus (rs12068753) demonstrated the most significant association with CRP in KD patients (beta = 4.73 and p = 1.20 * 10 -6 according to the stage 1 GWAS; beta = 3.65 and p = 1.35 * 10 -8 according to the replication study; beta = 3.97 and p = 1.11 * 10 -13 according to combined analysis) and explained 8.1% of the phenotypic variation observed. However, this SNP did not demonstrate any significant association with CRP in the general population (beta = 0.37 and p = 0.1732) and only explained 0.1% of the phenotypic variation in this instance. Furthermore, rs12068753 did not affect the development of coronary artery lesions or intravenous immunoglobulin resistance in KD patients. These results indicate that common variants in the CRP promoter can play an important role in the CRP levels in KD.

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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

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v32i2.26032 ◽

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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CORRELATION OF TOTAL COUNT (WBC), NEUTROPHIL COUNT AND CRP TEST AMONG FEBRILE PATIENTS IN NAVIMUMBAI.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i9.525 ◽

2019 ◽

Vol 3 (9) ◽

Author(s):

Dr. Sarita Shrivatstva ◽

Dr. Narayana Kamath ◽

Mrs. Ashwini Panchmahalkar

Keyword(s):

Neutrophil Count ◽

Bacterial Infections ◽

Blood Count ◽

Complete Blood Count ◽

Malarial Parasite ◽

Differential Count ◽

C Reactive Protein ◽

Reactive Protein ◽

Streptolysin O ◽

Febrile Condition

150 febrile patients included children (50), adult (50) and neonates (50) from outpatient departments and inpatients of private clinics and hospitals. Patients presented with fever and chills for more than 1 day to 3 days, throat infection, ear infection and cold and fever and only fever as the principal symptoms. After clinical examination all the patients were prescribed for Complete Blood Count (CBC) with differential count(DC) and C-reactive protein(CRP) tests, and in children below 14 years anti-Streptolysin O(ASO) tests ( 75) were prescribed. Patients treated with antibiotics previously two weeks before the study period were not included. Qualitative and quantitative tests were performed on all patients’ samples included in the study depending on the need/prescription by the physician or paediatrician. CBC, neutrophil count and CRP have been very useful indicators and significant in the diagnosis and treatment as well as follow-up of the febrile condition of the patients specially in patients suffering with bacterial infections. Even in patients with Dengue and malaria it gives a fair idea if there were leucocytosis or leukopenia, neutrophilia or neutropenia, thrombocytosis or thrombocytopenia. CBC: Complete blood count, DC: Differential count; MP: malarial parasite, CRP: C-reactive protein, ASO: Anti-Streptolysin O.

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