Fever, abnormal white blood cell count, neutrophilia, and elevated serum c-reactive protein in adult hospitalized patients with bacteremia
Southern Medical Journal, 09/20/2012 Manian FA et al.
Absence of fever, normal white blood cell count (WBC), and lack of neutrophilia are common in patients with bacteremia and may be confounded by a variety of factors; however, serum C–reactive protein (CRP) remains elevated in the majority (>98%) of bacteremic episodes.
Frequencies of fever (temperature ≥100°F), abnormal WBC count (≥10,000/μL or <4500/ μL), neutrophilia (neutrophils ≥80%) and potential factors that may be associated with negative results, and frequency of elevated serum CRP were studied retrospectively in 622 bacteremic episodes in adult patients at a community teaching hospital.
The frequencies of individual parameters were as follows: fever, 78.4% (95% confidence interval [CI] 74.9%–81.6%); abnormal WBC count, 65.2% (95% CI 61.3%–69.0%); neutrophilia, 67.5% (95% CI 63.7%–71.2%); and elevated CRP (>0.8 mg/dL), 98.4% (95% CI 97%–99.2%).
Age 50 years and older, corticosteroid use, and isolation of either Staphylococcus sp not aureus or Enterococcus sp combined were independently associated with the absence of fever (P ≤ 0.01 for all).
Isolation of Staphylococcus sp not aureus/Enterococcus and lack of corticosteroid use were independently associated with normal WBC (P < 0.05 for both).
Nonwhite race and primary bacteremia were independently associated with lack of neutrophilia (P < 0.05 for both).
MDLinx connects healthcare professionals and patients to tomorrow's important medical news, while providing the pharmaceutical and healthcare industries with highly targeted interactive marketing, education, content, and medical research solutions.