Fever and laboratory profiles as predictors of serious bacterial infection in children

Ni Putu Veny Kartika Yantie; BNP Arhana; Purnomo Suryantoro

doi:10.14238/pi52.6.2012.313-6

Ni Putu Veny Kartika Yantie Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
BNP Arhana Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
Purnomo Suryantoro Department of Child Health, Gadjah Mada University Medical School/.Dr, Sardjito Hospital, Yogyakarta, Central Java

DOI: https://doi.org/10.14238/pi52.6.2012.313-6

Keywords: serious bacterial infection, fever, leukocytes, neutrophil, C-reactive protein, children

Abstract

Background There is a debate on the use of high fever \\lith other
morbidities to predict serious bacterial infection (SBI). Bacterial
infection occurs in 3ô€‰15% of children with fever of 2: 39Â°C.
Various laboratory parameters including increased Cô€‰reactive
protein (CRP) levels, leukocyte counts, and absolute neutrophil
counts (AN C) have been studied for their usefulness in predicting
the occurrence of SBI, but with varied results. The ability to
discriminate whether a patient has a SBI can lead to improved
patient management.
Objective To evaluate fever of 2: 39Â°C, leukocyte counts of
2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL as
predictors of SBI in children aged 1 monthô€‰ 18 years.
Methods A caseô€‰controlled study was conducted by collecting
data from medical records at Sanglah Hospital, Denpasar. Subjects
in the case group were diagnosed \\lith SBls (bacterial meningitis,
bacterial pneumonia, bacteremia or sepsis, urinary tract infections,
or bacterial gastroenteritis), and subjects in the control group non
serious bacterial infections (nonô€‰SBI). Data was analyzed using
bivariate and multivariate methods \\lith 95% confidence intervals
and a statistical significance value ofP <0.05.
Results Sixty subjects were studied, \\lith 30 subjects in the case
group and 30 in the control group. Baseline characteristics of
subjects were similar between the two groups. Fever and CRP were
predictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P ô€€ 0.009; and
OR 6.20 (95% CI 1.58 to 24.24), P ô€€ 0.012, respectively].
Conclusion Fever 2: 39Â°C and CRP 2: 10 mgiL were significant
predictors of serious bacterial infections in children. [Paediatr
rndones, 2012;52:313-6].

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