The Value of Demographic, Clinical Characteristics, and Laboratory Parameters in Detecting Clinically Uncertain Serious Bacterial Infections in 36 Month-Old Children with Acute Fever without A Focus Akut Odağı Olmayan 36 Aylık Ateşli Çocuklarda Demografik, Klinik Özellikler ve Laboratuvar Parametrelerinin Gizli Bakteriyemiyi ve Klinik Olarak Belirsiz Ciddi Bakteriyel Enfeksiyonları Saptamadaki Değeri


Şahiner A., Tanır G.

Gazi Medical Journal, vol.33, no.1, pp.10-14, 2022 (Peer-Reviewed Journal) identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.12996/gmj.2022.03
  • Journal Name: Gazi Medical Journal
  • Journal Indexes: Emerging Sources Citation Index, Scopus, Academic Search Premier
  • Page Numbers: pp.10-14
  • Keywords: Absolute neutrophil count, C-reactive protein, Erythrocyte sedimentation rate, Fever, Serious bacterial infection, White blood cell count

Abstract

© 2022 Gazi Universitesi. All rights reserved.Objective: To recognize clinically uncertain serious bacterial infections in order to prevent the risk of permanent sequelae and mortality, which is the most important problem in children with acute fever without a focus. In our study, we aimed to retrospectively evaluate the diagnostic methods we used to detect serious bacterial infection (SBI) in patients hospitalized with the diagnosis of acute fever without a focus. Methods: This study was carried out by retrospectively scanning the files of the patients who were hospitalized in the pediatric infectious diseases clinic of our hospital between January 2008 and December 2012. Demographic data of the patients, clinical data such as duration of fever, symptoms accompanying fever, physical examination findings, and complete blood count, peripheral smear, C-reactive protein (CRP), erythrocyte sedimentation rates (ESR) were evaluated. The effectiveness of these clinical, demographic and laboratory findings in determining SBI was researched. Limit values for acute phase reactants and fever were determined, and the sensitivity of these parameters in detecting SBI was examined. Results: SBI was detected in 45 (30.4%) of 148 patients included in the study. Presence of toxic granulation, white blood cell count, absolute neutrophil count (ANC), CRP level and ESR were significant in determining serious bacterial infection (p=0.01, p=0.01, p=0.002, p=0.001, p=0.000, respectively), other parameters were found to be insignificant. It was determined that ANC ≥10000/mm3, CRP≥20 mg/L and ESR ≥30 mm/hour were significant in determining SBI. Conclusion: Although it is not a perfect test to diagnose SBI in patients with acute fever without a focus, white blood cell count, ANC, ESR, and CRP have important values in determining SBI.