Document Detail

Should complete blood count be part of the evaluation of febrile infants aged ≤2 months?
MedLine Citation:
PMID:  20367618     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the utility and importance of total white blood cell count (WBC) and absolute neutrophil count (ANC) as markers of serious bacterial infection (SBI) in hospitalized febrile infants aged ≤2 months.
PATIENTS AND METHODS: Data on WBC and ANC were collected prospectively for all infants aged ≤2 months who were hospitalized for fever at our centre. The patients were divided into two groups by the presence or absence of SBI.
RESULTS: A total of 1257 infants met the inclusion criteria, of whom 134 (10.7%) had a SBI. The area under the ROC curve was 0.73 (95% CI: 0.67-0.78) for ANC, 0.70 (95% CI: 0.65-0.76) for %ANC and 0.69 (95% CI: 0.61-0.73) for WBC. The independent contribution of these three tests in reducing the number of missed cases of SBI was significant.
CONCLUSION: Complete blood cell count should remain as part of the routine laboratory assessment in this age group as it is reducing the number of missing infants with SBI. Of the three parameters, ANC and %ANC serve as better diagnostic markers of SBI than total WBC. However, more accurate tests such as C-reactive protein and procalcitonin should also be part of the evaluation of febrile infants in these age group as they perform better than WBC or ANC for predicting SBI.
Efraim Bilavsky; Havatzelet Yarden-Bilavsky; Jacob Amir; Shai Ashkenazi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  99     ISSN:  1651-2227     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  1380-4     Citation Subset:  IM    
Copyright Information:
© 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.
Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
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MeSH Terms
Bacterial Infections / diagnosis*
Biological Markers
Fever of Unknown Origin / diagnosis*
Infant, Newborn
Leukocyte Count*
Logistic Models
Neutrophils / metabolism*
ROC Curve
Sensitivity and Specificity
Reg. No./Substance:
0/Biological Markers

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