Protein C as a Differential Marker for Bacterial Infection among Pediatric Patients with Fever

Mo, Eun Ha; Nam, In Hae; Park, Kyung Duk

Abstract

PURPOSE
This study was performed to find the clinical significance in protein C as a differential marker in the beginning stage of infection and prognosis factor in severe infection among pediatric patients who were admitted due to fever.
METHODS
A total of 40 pediatric patients who had temperatures higher than 37.5degrees C on admission at the Department of Pediatrics, Chungnam National University between December, 2002 and August, 2003 were enrolled. Total white blood cell count(WBC), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and protein C were performed for those patients on admission. Clinical progress, diagnosis and prognosis were reviewed for these patients. The 40 patients were divided into two groups based on the diagnosis of bacterial and nonbacterial infections.
RESULTS
Twenty patients(50%) were suspected of bacterial infections that showed positive results in blood, sputum, urine, and spinal cord fluid. There were eight cases with bacterial pneumonia, five with urinary tract infection, four with bacterial meningitis, two with cellulitis, and one with typhoid fever. The remaining 20 patients were diagnosed with nonbacterial infections because they had negative results in blood cultures. ESR and CRP were increased beyond normal range in both groups. However, protein C was significantly decreased in the bacterial infection group and yet normal range in the nonbacterial infection group(P<0.05).
CONCLUSION
Protein C can be used as a differential marker in order to distinguish between bacterial and nonbacterial infections. In addition, protein C can possibly be used as a prognostic factor that can predict severe infection.