Factors predicting serious bacterial infections in febrile infants less than three months old : multivariate analysis AIM : To identify … (2005 Apr)
factors predicting serious bacterial infections in febrile infants less than three months old : multivariate analysis AIM : To identify predictive factors of the presence of a serious bacterial infection ( SBI ) in febrile infants less than three months old . methods : retrospective analysis of the medical files of 315 consecutive consultations of febrile infants less than three months old in the pediatric emergency department of a french hospital , with logistic regression multivariate analysis of the different criteria routinely considered and C reactive protein ( CRP ) . results : SBI were diagnosed in 79 ( 25 . 1 ) infants , primarily urinary tract infections ( 71 ; 22 . 5 ) . One of these 79 children had pneumococcal meningitis but met the classical criteria for low risk of SBI : he died because antibiotics were not prescribed sufficiently early . factors significantly associated with SBI were : male sex ; temperature 38 . 5 degrees C and lasting 24 hours ; poor general condition ; absence of ear , nose and throat symptoms ; high white blood cell count with 50 neutrophils ; and serum CRP concentration 20 mg / l . multivariate analysis entering all these items retained only the latter two ( respectively , OR : 13 . 5 , 95 CI : 6 . 5 28 . 2 and OR : 2 . 9 ; 95 CI : 1 . 3 6 . 3 ) . CRP 20 mg / l …

Streptococcus pneumoniae evades complement attack and opsonophagocytosis by expressing the pspC locus encoded Hic protein that binds to short consensus … (2002 Feb)
streptococcus pneumoniae evades complement attack and opsonophagocytosis by expressing the pspC locus encoded Hic protein that binds to short consensus repeats 8 11 of factor H . streptococcus pneumoniae is an important cause of upper and lower respiratory tract infections , meningitis , peritonitis , bacterial arthritis , and sepsis . Here we have studied a novel immune evasion mechanism of serotype 3 pneumococci , which are particularly resistant to phagocytosis . On their surfaces the bacteria express the factor H binding inhibitor of complement ( Hic ) , a protein of the pneumococcal surface protein C family . using radioligand binding , microtiter plate assays , surface plasmon resonance analysis , and recombinant constructs of factor H , we located the binding site of Hic to short consensus repeats ( SCRs ) 8 11 in the middle part of factor H . This represents a novel microbial interaction region on factor H . The only other ligand known so far for SCRs 8 11 of factor H is C reactive protein ( CRP ) , an acute phase protein that binds to the pneumococcal C polysaccharide . The binding sites of Hic and CRP within the SCR8 11 region were different , however , because CRP did not inhibit the binding of Hic and required calcium for binding . binding of factor H to Hic expressing pneumococci promoted factor I mediated cleavage of C3b and restricted phagocytosis of pneumococci . Thus , virulent pneumococci avoid complement attack and opsonophagocytosis …

Is C reactive protein useful in the management of children with suspected bacterial meningitis ? C reactive protein ( CRP … (1984 Jul)
Is C reactive protein useful in the management of children with suspected bacterial meningitis ? C reactive protein ( CRP ) was evaluated in both serum and cerebrospinal fluid in 119 patients to determine if either or both measurements were of clinical value in the diagnosis of bacterial meningitis . CSF C reactive protein is too insensitive ( sensitivity 66 ) to be useful , while serum CRP is too nonspecific for routine application . serum CRP may have a role if used selectively in those patients with a low grade CSF pleocytosis and a negative Gram s stain .

Value of C reactive protein measurement in tuberculous , bacterial , and viral meningitis. (1984 Aug)
value of C reactive protein measurement in tuberculous , bacterial , and viral meningitis . The value of C reactive protein measurement in the differential diagnosis of meningitis was assessed in a population where tuberculous meningitis is prevalent . C reactive protein was measured serially with a sensitive radioimmunoassay in sera from 31 children with bacterial meningitis , 15 with tuberculous meningitis ( 6 with miliary tuberculosis ) , and 28 with viral meningitis . concentrations of C reactive protein in patients with tuberculous meningitis lay between those of patients with bacterial and viral meningitis a finding which detracts from the virtually absolute discrimination C reactive protein measurement allows between bacterial and viral meningitis . In all but two of the patients with tuberculous meningitis , C reactive protein concentrations fell rapidly after treatment began and became normal after 10 days . This fall did not , however , exclude the development of hydrocephalus as a complication . measurement of C reactive protein remains a useful additional parameter in the diagnosis and management of the various types of meningitis .

Does the estimation of acute phase protein concentrations in cerebrospinal fluid and / or in serum in patients with viral … (2003 Apr)
Does the estimation of acute phase protein concentrations in cerebrospinal fluid and / or in serum in patients with viral meningitis carry diagnostic importance ? Part I . lymphocytic meningitis caused by epidemic parotitis objective : We examined whether an acute phase reaction could occur in children with lymphocytic meningitis of homogeneous etiology ( parotitis epidemic from the paramyxoviridae family ) , a sign of which would be an increase in concentrations of acute phase proteins ( APP s ) in cerebrospinal fluid ( CSF ) and / or in blood serum . We also tested the usefulness of the determination of selected APP s concentrations in CSF and serum in diagnosis and monitoring of the course of the disease , provided that an increase in concentrations of selected APP s were discernible . methods : cases were 78 children with lymphocytic meningitis as a complication of parotitis epidemic . controls were 30 healthy children ( control group K1 ) and 19 children hospitalized with suspected meningitis ( control group K2 ) . The following APP s presence in CSF and serum were tested : C reactive protein ( CRP ) , alpha 2 haptoglobin ( HPT ) , alpha 1 antitripsin ( AAT ) and alpha 1 acid glycoprotein ( AAG ) , alpha 2 ceruloplasmin ( CER ) and alpha 2 macroglobulin ( AMG ) . The results were compared and analyzed . results : The results of the research show a significant increase in all APP s …

Cerebrospinal fluid adenosine deaminase activity and C reactive protein in tuberculous and partially treated bacterial meningitis. (1996 Jul)
cerebrospinal fluid adenosine deaminase activity and C reactive protein in tuberculous and partially treated bacterial meningitis . adenosine deaminase ( ADA ) activity measurement and C reactive protein ( C RP ) detection were done in CSF of 27 tuberculous meningitis ( TBM ) and 8 patients of partially treated bacterial meningitis , apart from routine biochemical tests . Both the groups had comparable CSF cell count , protein and sugar concentrations . The mean CSF ADA activity was significantly raised in TBM as compared to partially treated bacterial meningitis patients ( p 0 . 05 ) . A cut off ADA level or 5 IU / L and C RP positively were used for differentiation of partially treated bacterial from TBM cases . based on this , the sensitivity and specificity of ADA and C RP were 62 . 5 , 88 . 9 and 75 , 100 , respectively . since both the tests are simple and take lesser time to perform , they can be used as rapid diagnostic tests to remove diagnostic dilemma between the two diseases .

C reactive protein in spinal fluid of children with meningitis. (1981 Oct)
C reactive protein in spinal fluid of children with meningitis . We have evaluated a commercially available latex agglutination system for the detection of C reactive protein in CSF by a prospective study of 56 patients with CSF pleocytosis . On initial lumbar puncture , C RP was detected in 100 ( 24 / 24 ) of patients with culture proven bacterial meningitis , compared to 6 ( 2 / 32 ) of patients in the nonbacterial group ( chi 2 c 44 . 8 , P less than 0 . 0001 ) . C RP in CSF had a sensitivity of 1 . 0 and a specificity of 0 . 94 for detecting culture positive , bacterial meningitis . It was a more sensitive test for differentiating bacterial from nonbacterial meningitis on initial CSF examination than was the number of CSF leukocytes , the absolute number of CSF polymorphonuclear leukocytes , CSF glucose concentration , CSF protein concentration , or Gram staining of CSF . detection of C RP by latex agglutination may prove to be a practical and reliable method for differentiating bacterial from nonbacterial meningitis .

The clinical usefulness of C reactive protein ( CRP ) determinations in bacterial meningitis and septicemia in infancy. (1974 Aug)
The clinical usefulness of C reactive protein ( CRP ) determinations in bacterial meningitis and septicemia in infancy .

Elevated serum C reactive protein in mumps orchitis. (2004 Dec)
elevated serum C reactive protein in mumps orchitis . A case of mumps orchitis with a high concentration of C reactive protein ( CRP ) prompted us to evaluate the inflammatory response in mumps complications . We compared the CRP titers in mumps patients with orchitis and meningitis . The serum CRP titers were significantly higher in the patients with orchitis than in those with meningitis .

Duration of the treatment of meningitis except in the neonatal period optimal treatment of bacterial meningitis raises three questions : … (1993 Aug)
duration of the treatment of meningitis except in the neonatal period optimal treatment of bacterial meningitis raises three questions : which antibiotic ? which dosage ? which duration ? The overall duration of antibiotherapy has been shortened since the last decade . If a short course treatment shows similar efficacy and rate of relapse , unnecessary prolonged course of treatment exposes to increased cost , duration of hospitalization and secondary effects . From 1979 , Gold et al in toronto treated all uncomplicated cases of meningitis for seven days and obtained satisfactory results . The first randomized trials evaluating optimal duration of treatment in meningitis were performed in 1985 by Lin et al : they showed no difference in terms of efficacy and complications between conventional and short term treatment . current rules in meningococcal meningitis consist of seven days or less on therapy , and 7 10 days for pneumococcal or haemophilus meningitis . The sequential follow up of C reactive protein ( CRP ) levels seems a useful tool for the management of bacterial meningitis .

White blood cell count , erythrocyte sedimentation rate and serum C reactive protein in meningitis : magnitude of the response … (1985 Feb)
white blood cell count , erythrocyte sedimentation rate and serum C reactive protein in meningitis : magnitude of the response related to bacterial species . white blood cell count ( WBC ) , erythrocyte sedimentation rate ( ESR ) and serum C reactive protein ( CRP ) were determined upon diagnosis of 61 children with bacterial meningitis in order to compare the responses evoked by different bacteria . The age of the patients and the duration of their symptoms were similar in all groups . WBC and ESR corresponded significantly with the bacterial species . The mean WBC in haemophilus influenzae ( n 44 ) , meningococcal ( n 11 ) and pneumococcal ( n 6 ) infection were 14 , 605 / microliters 19 , 391 / microliters and 23 , 833 / microliters , respectively ( for H . influenzae and pneumococci p less than 0 . 001 ) . The mean ESR varied from 58 mm / h ( meningococci ) to 100 mm / h ( pneumococci ) ( p less than 0 . 025 ) . CRP was the test least influenced by the nature of the bacteria . The characteristics of CRP suggest its superiority over WBC and ESR as a detector of bacteremic infections . WBC is unsuitable for screening of systemic H . influenzae disease .

Serum C reactive protein in the differential diagnosis of acute meningitis. (1994 Feb)
serum C reactive protein in the differential diagnosis of acute meningitis . The ability of serum C reactive protein ( S CRP ) to differentiate between acute bacterial and viral meningitis was evaluated in 235 patients , both children and adults . The patients underwent lumbar puncture due to suspected central nervous system ( CNS ) infection . In patients with bacterial meningitis , 7 / 60 ( 12 ) had S CRP concentrations below 50 mg / l . Of these patients , 4 were children below 6 years of age , all with symptoms of meningitis for less than 12 h before admission and 3 adults of whom 1 had symptoms of meningitis for less than 12 h . In patients with viral meningitis , 15 / 146 ( 10 ) had S CRP concentrations above 50 mg / l . Only 3 children below 6 years of age with viral meningitis had S CRP concentration above 20 mg / l , but none exceeded 50 mg / l . An S CRP value above 50 mg / l in patients with CSF pleocytosis usually indicates bacterial etiology . however , S CRP values above 50 mg / l may occasionally be seen in viral meningitis . In children younger than 6 years of age a discriminatory level for S CRP of 20 mg / l can be used to distinguish between bacterial and viral meningitis , but for older patients a discriminatory level of 50 mg / …

The value of C reactive protein for the differentiation of bacterial meningitis from viral meningitis In order to differentiate bacterial … (1998 May)
The value of C reactive protein for the differentiation of bacterial meningitis from viral meningitis In order to differentiate bacterial meningitis versus viral meningitis , we have comparatively tested the efficacy of the following tests : C reactive protein ( CRP ) , erythrocytes sedimentation rate ( ESR ) , fever , level of glucose in cerebro spinal fluid ( CSF ) , glucose in CSF / glycemia ratio , number of white blood cells in peripheric blood , percentage of neutrophils in peripheric blood , level of proteins in CSF and number of nucleated cells in CSF for a group of 49 patients , both children and adults with central nervous system infection ( 37 patients with bacterial meningitis and 12 with viral meningitis ) hospitalised between May 1993 and July 1994 in clinical hospital for infectious diseases in Iaşi . The mean value of CRP in bacterial meningitis patients was 8 . 78 mg , contrasting with the mean value of CRP 1 . 92 mg recorded in patients with viral meningitis . Ten out of 37 bacterial meningitis patients presented a CRP concentration 1 . 85 mg . All these 10 patients have already had an antibiotic treatment at the moment of the assay . One out of 12 cases of viral meningitis had a value of CRP 3 . 3 mg , all the remainder cases having values under 1 . 85 mg . We recorded highly significant differences between the two patient groups for CRP …

Cerebrospinal fluid C reactive protein in the diagnosis of meningitis in children. (1995 Apr)
cerebrospinal fluid C reactive protein in the diagnosis of meningitis in children . C reactive protein was evaluated in the cerebrospinal fluid of 250 patients to determine if its measurement is of any clinical value in the diagnosis of bacterial meningitis . The C reactive protein was found to be significant in the diagnosis of bacterial meningitis .

Levels of interleukin 6 , CRP and alpha 2 macroglobulin in cerebrospinal fluid ( CSF ) and serum as indicator … (1998 Feb)
levels of interleukin 6 , CRP and alpha 2 macroglobulin in cerebrospinal fluid ( CSF ) and serum as indicator of blood CSF barrier damage . We measured the levels of interleukin 6 ( IL 6 ) , albumin , C reactive protein ( CRP ) and alpha 2 macroglobulin ( alpha 2M ) , all of which have different spectrums of molecular weight , in the cerebrospinal fluid ( CSF ) and serum in 121 patients to evaluate damage to the blood cerebrospinal fluid barrier ( BCB ) in meningitis . there was an extraordinary high level of IL 6 in the CSF when patients had bacterial or viral meningitis , but the level returned to a normal range within a week in almost all of these cases . there were no significant differences in CSF albumin levels among the different disease groups . The CRP level in CSF is considered to correlate with the serum level , and CSF CRP was higher in bacterial meningitis than in viral meningitis , however , CRP in CSF was increased in some of the infectious diseases without meningitis . The alpha 2M in CSF , which tends to be at extraordinarily high levels when there is damage to the BCB , correlated highly with CSF cell counts . CSF IL 6 seemed to be a useful indicator to identify the acute active phase of meningitis . CRP and alpha 2M in CSF are considered to be useful to differentiate bacterial meningitis …

Management of postoperative fever in cardiovascular surgery. (1998 Apr)
management of postoperative fever in cardiovascular surgery . background : The causes and management of postoperative fever were studied . materials AND methods : during a four year period beginning in january of 1991 , high fever over 38 . 5 degrees C max occurred in twenty five ( 6 ) out of 395 patients who underwent cardiovascular surgery . results : Nine of the patients ( 28 ) evidenced bacteriological infections as follows ; 3 cases of mediastinitis , 2 cases of respiratory tract infection , 1 case of MRSA colitis and a wound infection in one case . The three patients with mediastinitis died and the two cases of MRSA were detected from the culture of pacemaker leads . bacteriological infection was not detected in other 18 ( 72 ) patients with fever . however , we speculated that the clinical causes of fever in 9 out of 18 patients were as follows ; catheter fever in 3 patients , acalculous cholecystitis in 2 , fungus infection in 2 , aseptic meningitis in one and viral myelitis in one patient . Two patients with acalculous cholecystitis recovered after percutaneous transhepatic gallbladder drainage . The causes of fever were not apparent in nine patients , however the source might be related to artificial prostheses used intraoperatively in five patients . C reactive protein ( CRP ) was elevated beyond 10 mg / dl in 13 ( 52 ) of the 25 patients . CRP increased in all seven bacteriologically …

Cerebrospinal fluid C reactive protein in the diagnosis of meningitis in children. (1989 Nov)
cerebrospinal fluid C reactive protein in the diagnosis of meningitis in children . The mortality rate of bacterial meningitis in infants and children is still high ( 40 50 ) . Such a mortality rate can be reduced by establishing a prompt and accurate diagnosis . until now the diagnosis of meningitis is still an important clinical problem . The examination of cerebrospinal fluid C reactive protein had been done in 44 clinical meningitis patients in the paediatrics department , Dr . sardjito general hospital qualitatively by means of latex agglutination slide test . cerebrospinal fluid C reactive protein was positive in 90 ( 18 / 20 ) of bacterial meningitis patients compared to 8 . 3 ( 2 / 24 ) of non bacterial meningitis patients . The sensitivity and specificity of cerebrospinal fluid C reactive protein were 90 and 91 . 7 respectively and these values were more sensitive and specific than those of white cell count , absolute polymorphonuclear , glucose and protein levels and the cerebrospinal fluid smear ( 50 80 and 80 91 respectively ) which had been performed in the diagnosis of meningitis . It can be concluded that the examination of cerebrospinal fluid C reactive protein can be used as a diagnostic tool of bacterial meningitis .

The use of cytokine and C reactive protein measurements in cerebrospinal fluid during acute infective meningitis. (1994 Sep)
The use of cytokine and C reactive protein measurements in cerebrospinal fluid during acute infective meningitis . cerebrospinal fluid ( CSF ) concentrations of C reactive protein ( CRP ) , tumour necrosis factor alpha ( TNF ) , interleukin 6 ( IL 6 ) , total protein ( TP ) and white cell count with differential ( WCC ) have been measured in 24 patients presenting with acute bacterial or viral meningitis and also in a non infected , non inflamed control group ( n 24 ) . In acute viral meningitis , CRP levels were not raised when compared to controls and there was a discordance between high levels of the primary inflammatory mediators ( IL 6 and TNF ) and the low measured CRP levels . CRP levels were raised in cases of bacterial meningitis . A concentration of 100 ng / mL CRP had a sensitivity of 87 for bacterial meningitis . TNF concentrations in the CSF were significantly raised in cases of acute bacterial meningitis ( P 0 . 001 ) . smaller but variable elevations were seen in the patients with acute viral meningitis . One patient , who succumbed to bacterial infection , showed low CSF levels of CRP , TNF and WCC but an elevated IL 6 concentration . another , presenting with low CSF WCC , had raised concentrations of CRP , TNF and IL 6 which pointed to the correct diagnosis of acute bacterial meningitis . The development of methods …

C reactive proteins , immunoglobulin profile and mycobacterial antigens in cerebrospinal fluid of patients with pyogenic and tuberculous meningitis. (1993 Apr)
C reactive proteins , immunoglobulin profile and mycobacterial antigens in cerebrospinal fluid of patients with pyogenic and tuberculous meningitis . cerebrospinal fluid ( CSF ) samples were collected from 12 patients with pyogenic meningitis ( PM ) , 19 with tuberculous meningitis ( TBM ) , 20 with clinically suspected but not definitely proved cases of tuberculous meningitis ( STBM ) and 12 normal controls . C reactive proteins , immunoglobulins G , A , M and mycobacterial antigens were estimated in the CSF samples . seven out of 51 ( 13 . 7 ) samples obtained from the patient groups were positive for CRP . immunoglobulins M and A were significantly raised in the PM group . When the TBM and STBM groups were compared with the controls a highly significant increase was obtained for all immunoglobulins . mycobacterial antigens / epitopes were identified in 36 . 8 samples with tbagb1 and TB68 H monoclonals and in 26 . 3 with wtb72 A2 . In case of patients with suspected TBM , 6 . 6 were positive with tbagb1 and wtb72 A2 and 13 . 3 with TB68 H . however , non tuberculous patients also reacted with wtb72 A2 ( 10 . 5 ) and TB68 H ( 21 . 0 ) . This is , to the authors knowledge , the first report on the presence of CRP in the CSF . technique for immunoglobulins in CSF is also updated in this paper . We infer that …

C reactive protein and orosomucoid determinations in a neonatal pathology unit We report the result of CRP and ORM assays … (1986 Dec)
C reactive protein and orosomucoid determinations in a neonatal pathology unit We report the result of CRP and ORM assays performed at the admission in the unit , in 157 neonates ( NN ) . The NN were divided into 3 groups : 122 controls ( group I ) , 21 having septicemia with or without meningitis but with symptoms of infection ( group II ) , 16 having a positive blood culture without symptom of infection ( group III ) . In group I , the CRP level does not depend on gestational age at birth , neither on the age at the assay . The level of ORM depends on both factors . neonatal infection leads to a very significant rise of the CRP rate ( often above 100 mg / l ) . The rise of ORM is not so dramatic . these data suggest that the assay of these two proteins are useful in the diagnosis of neonatal infection if they are performed together and at several times .