Skip to main content
SpringerLink
Log in

White blood cell count, erythrocyte sedimentation rate and serum C-reactive protein in meningitis: Magnitude of the response related to bacterial species

Leukozytenzahl, Blutkörperchensenkungsgeschwindigkeit und C-reaktives Protein im Serum bei Meningitis: Ausmaß der Reaktion in Beziehung zur Bakterienspezies

  • Brief Communication
  • Published:
Infection Aims and scope Submit manuscript

Summary

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 inHaemophilus influenzae (n=44), meningococcal (n=11) and pneumococcal (n=6) infection were 14,605/µl, 19,391/µl and 23,833/µl, respectively (forH. influenzae and pneumococci p<0.001). The mean ESR varied from 58 mm/h (meningococci) to 100 mm/h (pneumococci) (p<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 systemicH. influenzae disease.

Zusammenfassung

Die Leukozytenzahl, Blutkörperchensenkungsgeschwindigkeit (BKS) und das C-reaktive Protein (CRP) wurden bei 61 Kindern mit bakterieller Meningitis zum Zeitpunkt der Diagnose bestimmt, um die durch verschiedene Bakterien verursachten Reaktionen zu vergleichen. In allen Gruppen waren Alter der Patienten und Dauer der Symptome ähnlich. Zwischen Leukozytenzahl, BKS und den verschiedenen Bakterien-Spezies bestand eine signifikante Beziehung. Die mittleren Leukozytenzahlen bei Infektionen durchHaemophilus influenzae (n=44), Meningokokken (n=11) und Pneumokokken (n=6) betrugen 14 605/µl, 19 391/µl und 23 833/µl (H. influenzae und Pneumokokken p<0,001). Die mittlere BKS lag zwischen 58 mm/h (Meningokokken) und 100 mm/h (Pneumokokken); (p<0,025). Das CRP wurde von den untersuchten Parametern am wenigsten von der Art der Bakterien beeinflußt. Die Eigenschaften des CRP lassen annehmen, daß es für den Nachweis bakteriämischer Infektionen der Leukozytenzahl und der BKS überlegen ist. Für das Screening auf systemische Erkrankungen durchH. influenzae ist die Leukozytenzahl ungeeignet.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literature

  1. Teele, D. W., Pelton, S. I., Myles, J. A., Grant, M. B., Herskowitz, J., Rosen, D. J., Allen, C. E., Wimmer, R. S., Klein, J. O. Bacteremia in febrile children under 2 years of age: Results of cultures of blood of 600 consecutive febrile children seen in a “walkin” clinic. J. Pediatr. 87 (1975) 227–230.

    Article  CAS  PubMed  Google Scholar 

  2. McCarthy, P. L., Jekel, J. F., Dolan, T. F. Temperature greater than or equal to 40° C in children less than 24 months of age: A prospective study. Pediatrics 59 (1977) 663–668.

    CAS  PubMed  Google Scholar 

  3. Teele, D. W., Marshall, R., Klein, J. O. Unsuspected bacteremia in young children. A common and important problem. Pediatr. Clin. North Am. 26 (1979) 773–784.

    Article  CAS  PubMed  Google Scholar 

  4. Carroll, W. L., Farrell, M. K., Singer, J. I., Jackson, J. A., Lobel, J. S., Levis, E. D. Treatment of occult bacteremia: A prospective randomized clinical trial. Pediatrics 72 (1983) 608–612.

    CAS  PubMed  Google Scholar 

  5. Clarke, D., Cost, K. Use of serum C-reactive protein in differentiating septic from aseptic meningitis in children. J. Pediatr. 102 (1983) 718–720.

    Article  CAS  PubMed  Google Scholar 

  6. Valmari, P., Kataja, M., Peltola, H. Bacterial meningitis in childhood. Duodecim 99 (1983) 1730–1740.

    CAS  PubMed  Google Scholar 

  7. Peltola, H. O. C-reactive protein for rapid monitoring of infections of the central nervous system. Lancet I (1982) 980–983.

    Article  Google Scholar 

  8. Valmari, P., Peltola, H., Ruuskanen, O. C-reactive protein as predictor of sequelae of meningitis. Lancet I (1984) 741–742.

    Article  Google Scholar 

  9. McCarthy, P. L., Frank, A. L., Ablow, R. C., Masters, S. J., Dolan, T. F. Value of C-reactive protein test in the differentiation of bacterial and viral pneumonia. J. Pediatr. 92 (1978) 454–456.

    Article  CAS  PubMed  Google Scholar 

  10. Peltola, H., Räsänen, J. A. Quantitative C-reactive protein in relation to erythrocyte sedimentation rate, fever, and duration of antimicrobial therapy in bacteraemic diseases of childhood. J. Infection 5 (1982) 257–267.

    Article  Google Scholar 

  11. Peltola, H. C-reactive protein in rapid differentiation of acute epiglottitis from spasmodic croup and acute laryngotracheitis: A preliminary report. J. Pediatr. 102 (1983) 713–715.

    Article  CAS  PubMed  Google Scholar 

  12. Peltola, H., Virtanen, M. SystemicHaemophilus influenzae infection. Clinical analysis of 813 cases seen in Finland in 1976–80 with special attention to forms other than meningitis and epiglottitis. Clin. Pediatr. 23 (1984) 275–280.

    Article  CAS  Google Scholar 

  13. Bennish, M., Beem, M. O., Ormiste, V. C-reactive protein and zeta sedimentation ratio as indicators of bacteremia in pediatric patients. J. Pediatr. 104 (1984) 729–732.

    Article  CAS  PubMed  Google Scholar 

  14. Harmoinen, A., Hällström, O., Grönroos, P. Rapid quantitative determination of C-reactive protein using lasernephelometer. Scand. J. Clin. Lab. Invest. 40 (1980) 293–295.

    Article  CAS  PubMed  Google Scholar 

  15. Harmoinen, A., Perko, M., Grönroos, P. Rapid quantitative determination of C-reactive protein using LKB 8600 reaction rate analyzer. Clin. Chim. Acta 111 (1981) 117–120.

    Article  CAS  PubMed  Google Scholar 

  16. Peltola, H., Laipio, M.-L., Siimes, M. A. Quantitative C-reactive protein (CRP) determined by an immunoturbidimetric method in rapid differential diagnosis of acute bacterial and viral diseases of children. Acta Paediatr. Scand. 73 (1984) 273–274.

    Article  CAS  PubMed  Google Scholar 

  17. Weitzman, M. Diagnostic utility of white blood cell and differential cell counts. Am. J. Dis. Child. 129 (1975) 1183–1189.

    CAS  PubMed  Google Scholar 

  18. Peltola, H., Holmberg, C. Rapidity of C-reactive protein in detecting potential septicemia. Pediatr. Infect. Dis. 2 (1983) 374–376.

    Article  CAS  PubMed  Google Scholar 

  19. Peltola, H. CRP as a detector of invasive bacterial infections and an indicator of the success of treatment. Duodecim 100 (1984) 390–400.

    CAS  PubMed  Google Scholar 

  20. Tillett, W. S., Francis, T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J. Exp. Med. 52 (1930) 561–571.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Oulu University Central Hospital, SF-90220, Oulu 22, Finland

    P. Valmari M.D.

Authors
  1. P. Valmari M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Valmari, P. White blood cell count, erythrocyte sedimentation rate and serum C-reactive protein in meningitis: Magnitude of the response related to bacterial species. Infection 12, 328–330 (1984). https://doi.org/10.1007/BF01651146

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01651146

Keywords

Search

Navigation