White Blood Cell (WBC) Count and C-Reactive Protein Value as Predictors of Bacterial Infections in Febrile Outpatient Children at Tabriz, Iran

Introduction and Objectives: Infections remain the major cause of unnecessary antibiotic use in pediatric outpatient settings. Complete blood count (CBC) is the essential test in the diagnosis of infections. C-reactive protein (CRP) is also useful for assessment of young children with serious bacterial infections. The purpose of the study was to evaluate leukocyte populations and CRP level to predict bacterial infections in febrile outpatient children. Materials and Methods: The values of CBC by Advia Siemens 2120i auto analyzer and serum CRP levels were evaluated in 60 febrile patients with documented infections (n:36 bacterial, n:24 viral) and 31 healthy controls at Tabriz Children s Hospital. Results: The mean CRP, neutrophil and Immature granulocyte (IG) values were significantly higher in bacterial infections than in viral infections and controls (p<0.05). C-reactive protein was significantly correlated with neutrophil level in bacterial infections (r: 0.76, p<0.05). Specificity of IG was greatest at 93%, only a modest 56% for neutrophil and mild 18% for CRP, whereas 100% for combination of IG, neutrophil and CRP. Conclusion: Acute bacterial infection seems to be very unlikely in children with normal leukocyte populations and CRP values, even if clinically signs and symptoms indicate acute bacterial infections.

Keywords:

White Blood Cell populations , C-reactive protein , Febrile children