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A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP

A first C-reactive protein (CRP) test, as often performed by clinicians during the presentation of patients with an acute bacterial infection, might be misleading. The aim of our study was to explore the dynamic between a second CRP test taken within 12 hours from admission CRP test in a cohort of p...

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Autores principales: Goldberg, Ilan, Shalmon, Dana, Shteinvil, Ronen, Berliner, Shlomo, Paran, Yael, Zeltser, David, Shapira, Itzhak, Shenhar-Tsarfaty, Shani, Meilik, Ahuva, Wasserman, Asaf, Goldiner, Ilana, Ziv-Baran, Tomer, Sprecher, Eli, Levinson, Tal, Rogowski, Ori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571963/
https://www.ncbi.nlm.nih.gov/pubmed/33080689
http://dx.doi.org/10.1097/MD.0000000000022551
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author Goldberg, Ilan
Shalmon, Dana
Shteinvil, Ronen
Berliner, Shlomo
Paran, Yael
Zeltser, David
Shapira, Itzhak
Shenhar-Tsarfaty, Shani
Meilik, Ahuva
Wasserman, Asaf
Goldiner, Ilana
Ziv-Baran, Tomer
Sprecher, Eli
Levinson, Tal
Rogowski, Ori
author_facet Goldberg, Ilan
Shalmon, Dana
Shteinvil, Ronen
Berliner, Shlomo
Paran, Yael
Zeltser, David
Shapira, Itzhak
Shenhar-Tsarfaty, Shani
Meilik, Ahuva
Wasserman, Asaf
Goldiner, Ilana
Ziv-Baran, Tomer
Sprecher, Eli
Levinson, Tal
Rogowski, Ori
author_sort Goldberg, Ilan
collection PubMed
description A first C-reactive protein (CRP) test, as often performed by clinicians during the presentation of patients with an acute bacterial infection, might be misleading. The aim of our study was to explore the dynamic between a second CRP test taken within 12 hours from admission CRP test in a cohort of patients diagnosed with acute bacterial infection in comparison to CRP in a control group of apparently healthy individuals. This was a historical cohort study comprised of all patients admitted to the Sourasky Tel-Aviv Medical Center, Israel, between July 2007 and March 2016. The study cohort included adult patients who were diagnosed as having an infection, assumed to be of bacterial etiology (cellulitis and erysipelas, pneumonia, cholecystitis, pyelonephritis, or septicemia), who had a CRP test during the first 6 hours of hospital admission (baseline CRP), and a successive CRP test up to 12 hours from the first one (recurrent CRP). The control group was of healthy subjects who attended our medical center for a routine annual check-up. The study included 950 patients. Baseline CRP ranged from 0.04 to 454 mg/L. The median CRP velocity was 0.53 mg/L/h. Patients were grouped by baseline CRP into 4 groups (CRP < 10, 10–74.9, 75–199.9, ≥200). There was an increase in median CRP velocity between the first (0.48 mg/L/h) and the second (0.93 mg/L/h) groups, which then was decreased in the next 2 groups (0.46 and −2.58 mg/L/h, respectively). In 45 of 103 (44%) patients of the group of baseline CRP concentration less than 10 mg/dL with bacterial diagnosis, there was a complete overlap with CRP values of apparently healthy individuals during their routine annual checkup. A first single low CRP result cannot exclude the presence of a significant bacterial infection. Patients with acute bacterial infection might present with a relatively low CRP value that at times correspond to normal limit CRP concentrations. A second test, obtained within 12 hours of admission, might serve as an important tool to identify patient with an evolving inflammatory burst commonly seen during acute bacterial infection.
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spelling pubmed-75719632020-10-29 A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP Goldberg, Ilan Shalmon, Dana Shteinvil, Ronen Berliner, Shlomo Paran, Yael Zeltser, David Shapira, Itzhak Shenhar-Tsarfaty, Shani Meilik, Ahuva Wasserman, Asaf Goldiner, Ilana Ziv-Baran, Tomer Sprecher, Eli Levinson, Tal Rogowski, Ori Medicine (Baltimore) 4900 A first C-reactive protein (CRP) test, as often performed by clinicians during the presentation of patients with an acute bacterial infection, might be misleading. The aim of our study was to explore the dynamic between a second CRP test taken within 12 hours from admission CRP test in a cohort of patients diagnosed with acute bacterial infection in comparison to CRP in a control group of apparently healthy individuals. This was a historical cohort study comprised of all patients admitted to the Sourasky Tel-Aviv Medical Center, Israel, between July 2007 and March 2016. The study cohort included adult patients who were diagnosed as having an infection, assumed to be of bacterial etiology (cellulitis and erysipelas, pneumonia, cholecystitis, pyelonephritis, or septicemia), who had a CRP test during the first 6 hours of hospital admission (baseline CRP), and a successive CRP test up to 12 hours from the first one (recurrent CRP). The control group was of healthy subjects who attended our medical center for a routine annual check-up. The study included 950 patients. Baseline CRP ranged from 0.04 to 454 mg/L. The median CRP velocity was 0.53 mg/L/h. Patients were grouped by baseline CRP into 4 groups (CRP < 10, 10–74.9, 75–199.9, ≥200). There was an increase in median CRP velocity between the first (0.48 mg/L/h) and the second (0.93 mg/L/h) groups, which then was decreased in the next 2 groups (0.46 and −2.58 mg/L/h, respectively). In 45 of 103 (44%) patients of the group of baseline CRP concentration less than 10 mg/dL with bacterial diagnosis, there was a complete overlap with CRP values of apparently healthy individuals during their routine annual checkup. A first single low CRP result cannot exclude the presence of a significant bacterial infection. Patients with acute bacterial infection might present with a relatively low CRP value that at times correspond to normal limit CRP concentrations. A second test, obtained within 12 hours of admission, might serve as an important tool to identify patient with an evolving inflammatory burst commonly seen during acute bacterial infection. Lippincott Williams & Wilkins 2020-10-16 /pmc/articles/PMC7571963/ /pubmed/33080689 http://dx.doi.org/10.1097/MD.0000000000022551 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 4900
Goldberg, Ilan
Shalmon, Dana
Shteinvil, Ronen
Berliner, Shlomo
Paran, Yael
Zeltser, David
Shapira, Itzhak
Shenhar-Tsarfaty, Shani
Meilik, Ahuva
Wasserman, Asaf
Goldiner, Ilana
Ziv-Baran, Tomer
Sprecher, Eli
Levinson, Tal
Rogowski, Ori
A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP
title A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP
title_full A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP
title_fullStr A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP
title_full_unstemmed A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP
title_short A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP
title_sort second c-reactive protein (crp) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low crp
topic 4900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571963/
https://www.ncbi.nlm.nih.gov/pubmed/33080689
http://dx.doi.org/10.1097/MD.0000000000022551
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