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

2020 ◽  
Vol 29 (1) ◽  
pp. 230949902096829
Author(s):  
Christina van Gerven ◽  
Kevin Eid ◽  
Tobias Krüger ◽  
Michael Fell ◽  
Daniel Kendoff ◽  
...  

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.

2017 ◽  
Vol 55 (4) ◽  
pp. 1205-1210 ◽  
Author(s):  
Mohan Natesan ◽  
Enoka Corea ◽  
Shivankari Krishnananthasivam ◽  
Harindra Darshana Sathkumara ◽  
Jennifer L. Dankmeyer ◽  
...  

ABSTRACT Melioidosis is a neglected tropical disease that is caused by the bacterium Burkholderia pseudomallei and is underreported in many countries where the disease is endemic. A long and costly administration of antibiotics is needed to clear infections, and there is an unmet need for biomarkers to guide antibiotic treatment and increase the number of patients that complete therapy. We identified calprotectin as a lead biomarker of B. pseudomallei infections and examined correlations between this serum protein and the antibiotic treatment outcomes of patients with melioidosis. Serum levels of calprotectin and C-reactive protein were significantly higher in patients with melioidosis and nonmelioidosis sepsis than in healthy controls. Median calprotectin levels were higher in patients with melioidosis than in those with nonmelioidosis sepsis, whereas C-reactive protein levels were similar in both groups. Notably, intensive intravenous antibiotic treatment of patients with melioidosis resulted in lower levels of calprotectin and C-reactive protein ( P < 0.0001), coinciding with recovery. The median percent reduction of calprotectin and C-reactive protein was 71% for both biomarkers after antibacterial therapy. In contrast, we found no significant differences in calreticulin levels between the two melioidosis treatment phases. Thus, reductions in serum calprotectin levels were linked to therapeutic responses to antibiotics. Our results suggest that calprotectin may be a sensitive indicator of melioidosis disease activity and illustrate the potential utility of this biomarker in guiding the duration of antibiotic therapy.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Sana Khedher ◽  
Nasreddine Fouthaili ◽  
Amira Maoui ◽  
Sirine Lahiani ◽  
Mohamed Salem ◽  
...  

Background. Bacterial infection (BI) represents the main cause of decompensation and death in cirrhotic patients. Procalcitonin (PCT) and C-reactive protein (CRP) are two widely used biomarkers that may be helpful for early detection of BI especially in the presence of inflammation. Their accuracy for the diagnosis of BI in patients with chronic liver disease has been a subject of debate. In this study, we aimed to learn whether PCT and CRP would be helpful as early markers of BI in patients with cirrhosis and to evaluate their prognostic value in terms of mortality. Subjects and Methods. We retrospectively included 92 adult patients with decompensated cirrhosis. PCT and CRP plasma levels were obtained within the first 24 hours of admission. Their diagnostic and prognostic values were compared using the appropriate statistical analysis. Results. Ninety-two patients were included. BI was diagnosed in 60 patients (65%). Mean white blood cell (WBC) count (p=0.005) and PCT and CRP serum levels (p<0.001) were higher in the BI group than in the non-BI (NBI) group. The diagnostic accuracy of CRP and PCT for the diagnosis of BI was better than that of WBC. CRP was the most sensitive marker (70%) while PCT was the more specific (96.6%). No one of those biomarkers was predictive of 3-month mortality in patients with BI. Conclusion. Regarding BI in patients with decompensated cirrhosis, CRP maintains efficiency slightly higher than that of the PCT without being discriminative. However, no prognostic value has been established for these markers.


2018 ◽  
Vol 30 (3) ◽  
pp. 7-12
Author(s):  
Enas N Muhammad ◽  
Saif S Saliem ◽  
Enas R Naaom

Background: Periodontitis (PD) is well-known chronic disease affecting the periodontal ligament and alveolar bone, Osteoarthritis (OA) is a chronic joint disease with compound reasons characterized by synovial inflammation, subchondral bone remodeling, also the formation of osteophytes, that cause cartilage degradation. Chronic periodontitis and osteoarthritis are considered widely prevalent diseases and related to tissue destruction due to chronic inflammation in general health and oral health. The aim of this study is todetermine the association of chronic periodontitis and osteoarthritits in patients by analysing tumor necrosis factor alpha TNFα and high sensitive c-reactive protein (hsCRP) in the serum. Materials and Method: A total of 80 patients of both sexes aged 35-50 years ,30 patients with osteoarthritis and moderate chronic periodontitis (CP+OA), 30 patients of both sexes aged 35-50 years with moderate chronic periodontitis alone (CP). And control group (C) of 20 healthy patients with healthy periodontium participated in this cross sectional study. we excluded the postmenopausal and pregnant woman from female patient and smoker patient also. All patients are free of medication and have good general health with no history of systemic disease. Participants with OA have documentation or radiographic imaging, consistent with degenerative arthritis in the absence of an inflammatory condition. Venous blood samples were drawn from each subject using pyrogen-free heparinized collection tubes. Tubes were centrifuged according to the manufacturer’s guidelines, then stored at -15°C till analyse. serum TNFα and hs CRP were measured using an enzyme-linked immunosorbent assay (ELISA). Results: A non-significant differences between studied group regarding serum level of hsCRP and TNF-α, as well as, the result revealed that the median of serum levels of hsCRP were little higher in chronic periodontitis with osteoarthritis group than chronic periodontitis group and control groups represent as 0.31, 0.29, and 0.24. Similarly, the medium serum level of TNFα was higher in chronic periodontitis with OAthan in other two groups (10.615, 10.533, and 9.682 respectively). The age and gender showed a non-significant difference between the groups Conclusion: The present study revealed that there’s a strong positive correlation between serum levels of hsCRP and TNFα in patients of all groups but there is no correlation between Osteoarthritis and chronic periodontitis.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R.A Montone ◽  
M Camilli ◽  
M Russo ◽  
M Del Buono ◽  
F Gurguglione ◽  
...  

Abstract Background Brain-derived neurotrophic factor (BDNF) is a neurotrophine that plays a key role in the regulation of both central and peripheral nervous system. Moreover, BDNF is secreted in multiple tissues and exerts systemic, autocrine, and paracrine effects in the cardiovascular system. Of importance, BDNF expression was enhanced in macrophages and smooth muscle cells in atherosclerotic coronary arteries and may be involved in thrombus formation. Thus, BDNF has been suggested as an important link between inflammation and thrombosis, potentially involved in the pathogenesis of acute coronary syndrome (ACS). Purpose In our study we aimed at assessing serum levels of BDNF in patients with ACS, evaluating differences according to clinical presentation [ST-segment elevation myocardial infarction (STEMI) vs. Non-ST-segment elevation ACS (NSTE-ACS)]. Moreover, we assessed the presence of optical coherence (OCT)-defined macrophage infiltrates (MØI) in the culprit vessel of ACS patients and evaluated their relationship with BDNF levels. Methods ACS patients were prospectively selected. Blood samples were collected at admission and serum levels of BDNF were subsequently assessed. Presence of OCT-defined MØI along the culprit vessel was assessed. Results 166 ACS patients were enrolled [mean age 65.3±11.9 years, 125 (75.3%) male, 109 STEMI, 57 NSTE-ACS]. Serum levels of BDNF were higher among STEMI patients compared with NSTE-ACS [median (IQR) 2.48 pg/mL (1.54–3.34) vs. 2.12 pg/mL (1.34–2.47), p=0.007], while C-reactive protein levels did not differ between the two groups. OCT assessment was performed in 53 patients and MØI were detected in 27 patients. Of importance, patients with MØI in the culprit vessel had higher levels of BDNF compared with patients without MØI [median (IQR) 2.23 pg/mL (1.38–2.53) vs. 1.41 pg/mL (0.93–2.07), p=0.023], while C-reactive protein levels did not differ between the two groups. Of note, at multivariate regression analysis BDNF levels were independent predictor of MØI [OR: 2.20; 95% CI (1.02–4.74), p=0.043]. Conclusions Serum levels of BDNF may reliable identify the presence of local macrophage inflammatory infiltrates in patients with ACS. Moreover, BDNF levels are higher in patients with STEMI compared with NSTE-ACS. Taken together, these data suggest that BDNF may represent an interesting link between local inflammatory activation and enhanced thrombosis in ACS. BDNF serum levels Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ademola Olusegun Talabi ◽  
Tewogbade Adeoye Adedeji ◽  
Oludayo Adedapo Sowande ◽  
Olusanya Adejuyigbe

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.


1990 ◽  
Vol 68 (21) ◽  
pp. 1083-1083 ◽  
Author(s):  
H. Tilg ◽  
J. Mair ◽  
M. Herold ◽  
W. E. Aulitzky ◽  
P. Lechleitner ◽  
...  

2017 ◽  
Vol 16 (2) ◽  
pp. 52-59
Author(s):  
Sotirios Kakavas ◽  
◽  
Aggeliki Papanikolaou ◽  
Evangelos Balis ◽  
Evgenios Metaxas ◽  
...  

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.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Jae-Jung Kim ◽  
Sin Weon Yun ◽  
Jeong Jin Yu ◽  
Kyung Lim Yoon ◽  
Kyung-Yil Lee ◽  
...  

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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