ON THE ISSUE OF DIFFERENTIAL DIAGNOSIS OF BACTERIAL INFECTIONS AND PEDIATRIC MULTISYSTEM INFLAMMATORY SYNDROME DURING THE COVID-19 PANDEMIC

During the COVID-19 pandemic, it is necessary to be wary of the development of pediatric multisystem inflammatory syndrome in children (PMIS) who have had a COVID-19 and had antibodies to the SARS-CoV-2 virus. The aim of this work is to describe two clinical cases in children with antibodies to SARS-CoV-2 against the background of yersiniosis in a 12-year-old child and salmonellosis in a 3-year-old child, which proceeded with a pronounced inflammatory reaction and required a differential diagnosis with multisystem inflammatory syndrome. These bacterial infections proceeded with severe intoxication and fever, had a polymorphic clinical picture with exanthema syndrome, conjunctivitis/scleritis, swelling of the palms/feet, diarrhea and toxic kidney damage, with a pronounced systemic inflammatory reaction – high leukocytosis with neutrophilia and lymphopenia, a significant increase in C-reactive protein, procalcitonin, hypercoagulability (increased fibrinogen, D-dimer). Etiotropic antibiotic therapy led to recovery in both cases. Conclusions: During the COVID-19 pandemic, if antibodies to the SARS-CoV-2 virus are detected in children in the presence of signs of systemic inflammation and corresponding symptoms, the alertness of doctors and a timely comprehensive examination are necessary to exclude bacterial infections, also characterized by signs of systemic inflammation, for the purpose of differential diagnosis of PMIS.

Download Full-text

C-Reactive Protein Is an Independent Predictor of 30-Day Bacterial Infection Post-Liver Transplantation

Biomolecules ◽

10.3390/biom11081195 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1195

Author(s):

Jiong Yu ◽

Xiaowei Shi ◽

Jing Ma ◽

Ronggao Chen ◽

Siyi Dong ◽

...

Keyword(s):

Liver Transplantation ◽

Bacterial Infection ◽

Systemic Inflammation ◽

Bacterial Infections ◽

Cox Regression ◽

Prognostic Models ◽

C Reactive Protein ◽

Reactive Protein ◽

Clinically Significant ◽

The Relationship

The relationship between aseptic systemic inflammation and postoperative bacterial infection is unclear. We investigated the correlation of systemic inflammation biomarkers with 30-day clinically significant bacterial infections (CSI) after liver transplantation (LT). This retrospective study enrolled 940 patients who received LT and were followed for 30 days. The primary end point was 30-day CSI events. The cohort was divided into exploratory (n = 508) and validation (n = 432) sets according to different centers. Area under the receiver operated characteristic (AUROC) and Cox regression models were fitted to study the association between baseline systemic inflammation levels and CSI after LT. A total of 255 bacterial infectious events in 209 recipients occurred. Among systemic inflammation parameters, baseline C-reactive protein (CRP) was independently associated with 30-day CSI in the exploratory group. The combination of CRP and organ failure number showed a good discrimination for 30-day CSI (AUROC = 0.80, 95% CI, 0.76–0.84) and the results were confirmed in an external verification group. Additionally, CRP levels were correlated with bacterial product lipopolysaccharide. In conclusion, our study suggests that pre-transplantation CRP is independent of other prognostic factors for 30-day CSI post-LT, and can be integrated into tools for assessing the risk of bacterial infection post-LT or as a component of prognostic models.

Download Full-text

Study on effect of kangyanling ("Equation missing" No EquationSource Format="TEX", only image )on cytokine and C-reactive protein inpatients of systemic inflammatory reaction syndrome and multi-organ dysfunction syndrome after abdominal surgery)on cytokine and C-reactive protein inpatients of systemic inflammatory reaction syndrome and multi-organ dysfunction syndrome after abdominal surgery

Chinese Journal of Integrated Traditional and Western Medicine ◽

10.1007/bf02935011 ◽

2001 ◽

Vol 7 (2) ◽

pp. 98-98

Author(s):

Zhe-yu Chen ◽

Qing-hui Qi

Keyword(s):

Abdominal Surgery ◽

Organ Dysfunction ◽

Inflammatory Reaction ◽

C Reactive Protein ◽

Reactive Protein ◽

Systemic Inflammatory Reaction ◽

Multi Organ Dysfunction Syndrome

Download Full-text

C-Reactive Protein Levels in Patients with Infectious Mononucleosis

10.21203/rs.3.rs-1091452/v1 ◽

2021 ◽

Author(s):

Alon Nevet ◽

Maanit Shapira

Keyword(s):

Differential Diagnosis ◽

Electronic Medical Records ◽

Infectious Mononucleosis ◽

Medical Records ◽

Bacterial Infections ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Serologic Evidence ◽

Host Characteristics

Abstract Background: Plasma level of C-reactive protein (CRP) is used as a biomarker of systemic inflammation. Differential distributions of CRP levels related to different pathogens aid clinicians in the differential diagnosis of patients.Objectives: To evaluate the distribution of CRP levels in patients with Infectious Mononucleosis (IMN) and its correlation with different pathogen and host characteristics.Methods: A retrospective study conducted on electronic medical records of patients diagnosed clinically and serologically with IMN in a public regional hospital during consecutive five years.Results: CRP levels were significantly elevated in patients hospitalized with clinical diagnosis of IMN and serologic evidence of EBV (average 6.8 md/dL) or CMV (average 6.3 md/dL). However, levels of CRP were not significantly correlated with plasma levels of liver enzymes. Conclusions: Although CRP levels may aid in the differential diagnosis of respiratory syndromes, its distribution in patients infected by hepatotrophic viruses is similar to that in bacterial infections.

Download Full-text

OC79 THE ROLE OF PROCALCITONIN, C-REACTIVE PROTEIN AND WHITE BLOOD CELLS IN THE DIFFERENTIAL DIAGNOSIS BETWEEN SEPSIS AND SIRS IN CARDIAC SURGERY PATIENTS

Journal of Cardiovascular Medicine ◽

10.2459/01.jcm.0000549931.77196.23 ◽

2018 ◽

Vol 19 ◽

pp. e32

Author(s):

D. Brugnetti ◽

K. Reeve ◽

U. Held ◽

H. Löblein ◽

D. Odavic ◽

...

Keyword(s):

Differential Diagnosis ◽

Cardiac Surgery ◽

Blood Cells ◽

White Blood Cells ◽

C Reactive Protein ◽

Reactive Protein

Download Full-text

Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1730124 ◽

2021 ◽

Author(s):

Hasan Hüseyin Özdemir ◽

Ahmet Dönder

Keyword(s):

Systemic Inflammation ◽

Tension Type Headache ◽

Neutrophil To Lymphocyte Ratio ◽

Control Group ◽

C Reactive Protein ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Significant Difference ◽

Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

Download Full-text

Value of measuring serum procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-005-1312-z ◽

2005 ◽

Vol 24 (4) ◽

pp. 272-275 ◽

Cited By ~ 36

Author(s):

G. L. Petrikkos ◽

S. A. Christofilopoulou ◽

N. K. Tentolouris ◽

E. A. Charvalos ◽

C. J. Kosmidis ◽

...

Keyword(s):

Bacterial Infections ◽

C Reactive Protein ◽

Reactive Protein

Download Full-text

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v27i2.1639 ◽

2021 ◽

Vol 27 (2) ◽

pp. 212

Author(s):

Brigitte Rina Aninda Sidharta ◽

JB. Suparyatmo ◽

Avanti Fitri Astuti

Keyword(s):

Acute Leukemia ◽

Predictive Value ◽

Bacterial Infections ◽

Fungal Infections ◽

Lymphoblastic Leukemia ◽

Negative Likelihood Ratio ◽

Receiver Operating Curve ◽

High Morbidity ◽

C Reactive Protein ◽

Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

Download Full-text

P4679Changes in systemic inflammation and endothelial dysfunction after balloon pulmonary angioplasty

European Heart Journal ◽

10.1093/eurheartj/ehz745.1061 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Cited By ~ 1

Author(s):

W Magon ◽

J Stepniewski ◽

K Jonas ◽

M Waligora ◽

P Podolec ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Serum Concentration ◽

Systemic Inflammation ◽

Interleukin 6 ◽

C Reactive Protein ◽

Pulmonary Hemodynamics ◽

Endothelin 1 ◽

Reactive Protein ◽

Balloon Pulmonary Angioplasty

Abstract Introduction Pulmonary endarterectomy leads to a decrease in systemic inflammation and improvement in endothelial function in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) improves pulmonary hemodynamics in patients with inoperable CTEPH. Aim To assess changes in systemic inflammation and endothelial dysfunction after a single BPA session and after completion of the treatment. Methods We enrolled consecutive, inoperable CTEPH patients who underwent BPA. Interleukin 6, 10 (IL-6, IL-10), and C-reactive protein (hsCRP) constituted markers of systemic inflammation. Endothelin-1 (ET-1) served as a marker of endothelial dysfunction. Serum concentration of selected markers was assessed in every patient before, 24 hours after the first BPA session and 6 months after completion of the BPA treatment. Age- and sex-matched healthy subjects served as a control group. Results We recruited 20 patients with inoperable CTEPH (6 males [30%]), aged 67 [61–74] years in New York Heart Association class III (n=19 [95%]) and II (n=1 [5%]). BPA treatment was completed with a median of 5 [2–8] BPA sessions per patient. Before starting the treatment CTEPH patients, as compared to controls (n=10), had raised serum level of IL-6 (3.82 [2.75 - 6.03] vs. 2.64 [0.88 - 4.75] pg/ml; p=0.04), hsCRP (2.47 [0.93 - 4.27] vs. 1.23 [0.48–3.21] ng/ml; p=0.02) and ET-1 (2.68 [2.24 - 3.64] vs. 1.47 [1.4 - 1.82] pg/ml; p=0.004). There was no difference in IL-10 level. 24 hours after a BPA session we observed an increased level of IL-6, IL-10 and hsCRP. (Tab.) 6 months after completion of the BPA treatment there was a reduced level of IL-6, hsCRP and ET-1 (Tab.) Table 1. Changes (Δ) in serum concentration of analyzed markers 24 hours after a single BPA session and at 6-months assessment after completion of the BPA treatment (n=20) Initial Δ at 24 hours after single BPA p Δ at 6-months follow-up p ET-1 [pg/ml] 2.68 [2.24; 3.64] −0.2 [−0.5; 0.23] 0.21 −0.47 [−0.96; 0.05] 0.004 IL-6 [pg/ml] 3.82 [2.75; 6.03] 3.67 [1.41; 7.16] 0.008 −0.82 [−3.11; 0.54] 0.04 IL-10 [pg/ml] 0.53 [0.44; 0.58] 0.32 [0.21; 0.87] 0.006 −0.11 [−0.33; 0.14] 0.94 hsCRP [ng/ml] 2.47 [0.93; 4.27] 5.4 [3.96; 10.59] 0.008 −0.36 [−0.94; 0.16] 0.02 ET-1, endothelin 1; hsCRP, C-reactive protein; IL-6, interleukin 6; IL-10, interleukin 10. Conclusions Patients with inoperable CTEPH, as compared to healthy controls, exhibit an increased systemic inflammation and endothelial dysfunction, which both improve after completion of the BPA treatment. At short-term follow-up after single BPA session there is an increase in systemic inflammatory response.

Download Full-text