Journal of Yeungnam Medical Science

Original article

Predictive value of C-reactive protein for the diagnosis of meningitis in febrile infants under 3 months of age in the emergency department: Tae Gyoung Lee, Seung Taek Yu, Cheol Hwan So; Yeungnam Univ J Med. 2020;37(2):106-111. Published online January 8, 2020; DOI: https://doi.org/10.12701/yujm.2019.00402

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Background
Fever is a common cause of pediatric consultation in the emergency department. However, identifying the source of infection in many febrile infants is challenging because of insufficient presentation of signs and symptoms. Meningitis is a critical cause of fever in infants, and its diagnosis is confirmed invasively by lumbar puncture. This study aimed to evaluate potential laboratory markers for meningitis in febrile infants.
Methods
We retrospectively analyzed infants aged <3 months who visited the emergency department of our hospital between May 2012 and May 2017 because of fever of unknown etiology. Clinical information and laboratory data were evaluated. Receiver operating characteristic (ROC) curves were constructed.
Results
In total, 145 febrile infants aged <3 months who underwent lumbar punctures were evaluated retrospectively. The mean C-reactive protein (CRP) level was significantly higher in the meningitis group than in the non-meningitis group, whereas the mean white blood cell count or absolute neutrophil count (ANC) did not significantly differ between groups. The area under the ROC curve (AUC) for CRP was 0.779 (95% confidence interval [CI], 0.701–0.858). The AUC for the leukocyte count was 0.455 (95% CI, 0.360–0.550) and that for ANC was 0.453 (95% CI, 0.359–0.547). The CRP cut-off value of 10 mg/L was optimal for identifying possible meningitis.
Conclusion
CRP has an intrinsic predictive value for meningitis in febrile infants aged <3 months. Despite its invasiveness, a lumbar puncture may be recommended to diagnose meningitis in young, febrile infants with a CRP level >10 mg/L.

Citations

Citations to this article as recorded by

Fever without a source under 3 months of age: any predictive factors of Serious Bacterial Infection?
Rita Calejo Pereira Machado Ribeiro, Joana Raquel Pinto de Carvalho Queiros, Ana Ines Rodrigues Paiva Ferreira, Ines Isabel Aires Martins, Fabio David Monteiro Barroso
Pediatric Oncall.2024;[Epub] CrossRef
Immunologic biomarkers for bacterial meningitis
Mina Yekani, Mohammad Yousef Memar
Clinica Chimica Acta.2023; 548: 117470. CrossRef
Febrile infants: written guidelines to reduce non-essential hospitalizations
Ji Yoon Oh, Soo-Young Lee
World Journal of Pediatrics.2021; 17(5): 555. CrossRef

Original Article

The Measurement of Blood Flow of Anterior Cerebral Artery in Premature Newborns Using Duplex Dopple Ultrasonography.: Mi Soo Hwang, Kyeung Kug Bae, Jae Kyo Lee; Yeungnam Univ J Med. 1997;14(1):77-84. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.77

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Abstract PDF: We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a use ful noninvasive means of monitoring cerebrohemodynamics in normal pretem neonates and flow change of sick babies.

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