Value of C-reactive protein determination in the initial diagnostic evaluation of the febrile, neutropenic child with cancer

J. A. Katz, M. M. Mustafa, R. O. Bash, J. V. Cash, G. R. Buchanan

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

We studied prospectively the value of admission C-reactive protein (CRP) in the diagnostic evaluation of the child with cancer hospitalized for fever and neutropenia. During a 7-month period 74 patients with malignant disease had 122 hospital admissions because of fever and neutropenia. All patients had a serum CRP obtained 8 to 24 hours after the onset of fever as part of their initial evaluation. There was a borderline correlation between serum CRP concentration and temperature at admission (P = 0.06). Patients with fever without an identifiable source had significantly lower CRP concentrations compared with those having focal or microbiologically documented infection (34.9 ± 6 vs. 70.2 ± 12 mg/liter; P = 0.0005). Twelve patients had positive blood cultures, 5 of which were coagulase-negative staphylococci considered to be central venous catheter-related infection or colonization. CRP concentrations were significantly lower in these 5 patients compared with the 7 patients with septicemia caused by other organisms (21 ± 9 vs. 113 ± 23 mg/liter; P = 0.01). In distinguishing between septicemic and nonsepticemic children, serum CRP was found to have excellent sensitivity and negative predictive value at concentration limits of 20, 50 and 100 mg/liter. However, both specificity and positive predictive value were low at these respective levels, thus limiting the overall utility of serum CRP in the initial empiric management of the febrile, neutropenic child with cancer.

Original languageEnglish (US)
Pages (from-to)708-712
Number of pages5
JournalPediatric Infectious Disease Journal
Volume11
Issue number9
StatePublished - 1992

Fingerprint

C-Reactive Protein
Fever
Blood Proteins
Neoplasms
Neutropenia
Catheter-Related Infections
Central Venous Catheters
Coagulase
Staphylococcus
Sepsis
Temperature
Infection

Keywords

  • bacteremia
  • C-reactive protein
  • child
  • neutropenia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pediatrics, Perinatology, and Child Health

Cite this

Value of C-reactive protein determination in the initial diagnostic evaluation of the febrile, neutropenic child with cancer. / Katz, J. A.; Mustafa, M. M.; Bash, R. O.; Cash, J. V.; Buchanan, G. R.

In: Pediatric Infectious Disease Journal, Vol. 11, No. 9, 1992, p. 708-712.

Research output: Contribution to journalArticle

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