Abstract:
To study the relationship between White Blood Cell (WBC), Absolute Neutrophil Count (ANC) in febrile children 1-18 months of age as predictor of bacterial infection, so as to improve our predictability of bacterial infections in emergency room to decrease unnecessary admissions and antibiotic use. Retrospective review was performed on febrile patients 1-18 months of age that were admitted to hospital between August 2002 and March 2003 on the presumptive diagnosis of fever without focus. Complete septic work up was done for all patients according to local hospital protocol including Complete blood count (CBC), blood culture, urine culture, Chest X-Ray (CXR) and lumbar puncture. Patients who had history of antibiotics use within 48 hours of admission were excluded from the study. History, physical examination, laboratory and radiology data were reviewed. Data about the age, sex, temperature, presence or absence of focal bacterial infection, WBC, ANC, CXR report & body fluid culture results were collected & analyzed. Thirty-four patients were reviewed in this study. Eight patients (23.5%) had bacterial infection: classified as group1 (2 patchy pneumonia, 3 Urinary tract infection (UTI), 2 meningitis, 1 Occult bacteremia (OB) and 26 patients (76.5%) had no evidence of bacterial infection, classified as group 2. No significant difference was found between the two groups in respect to age, sex, temperature and WBC P>0.05, while there was a significant difference between the two groups in respect to the ANC P = 0.02, also ANC had better sensitivity (78%) and specificity (89%) than WBC (sensitivity 77%, specificity 62%). ANC is a good predictive test for determining bacterial infection in young febrile children without focus. However there is need for other more reliable rapid cost effective measures in dealing with young febrile children at emergency department. OB=Occult bacteremia, UTI=Urinary tract infection, CBC=Complete blood count, WBC=White blood cell, ANC=Absolute neutrophil count, CRP=C- reactive protein, CXR=Chest X ray, CSF=Cerebrospinal fluid, LP=Lumber puncture.
Page(s):
97-100
DOI:
DOI not available
Published:
Journal: Pakistan Journal of Medical Sciences, Volume: 20, Issue: 2, Year: 2004