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Am. J. Trop. Med. Hyg., 70(5), 2004, pp. 580-582
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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C-REACTIVE PROTEIN IN THE DIAGNOSIS OF MELIOIDOSIS

ALLEN C. CHENG, MATTHEW O’BRIEN, SUSAN P. JACUPS, NICHOLAS M. ANSTEY, AND BART J. CURRIE
Infectious Diseases Unit, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia; Northern Territory Clinical School, Flinders University, Darwin, Australia; Division of Medicine, Royal Darwin Hospital, Darwin, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Australia

Previous work suggested that C-reactive protein (CRP) may be a useful test in the diagnosis of melioidosis, the infection caused by Burkholderia pseudomallei. We reviewed patients with culture-confirmed melioidosis to define the role of this inflammatory marker in the diagnosis of melioidosis. In 175 patients, we found that the admission CRP level may be normal or only mildly elevated, including patients with severe sepsis, fatal cases, and in relapsed melioidosis. In a multivariate analysis, sepsis and bacteremia were more strongly associated with mortality than CRP. Admission levels of CRP are not a sensitive marker for the presence of melioidosis and a normal level cannot be used to exclude acute, chronic, or relapsed melioidosis in febrile patients in or from endemic regions.

Received August 27, 2003. Accepted for publication January 19, 2004.

Acknowledgments: We thank John Engemann and John Rampton for data support and preliminary analysis.

Financial support: Allen C. Cheng is supported by a National Health and Medical Research Council (NH&MRC) Research Training Scholarship, and Nicholas M. Anstey supported by an NH&MRC Practitioner Fellowship.

Authors’ addresses: Allen C. Cheng, Susan P. Jacups, Nicholas M. Anstey, and Bart J. Currie, Infectious Diseases Unit, Menzies School of Health Research, PO Box 41096, Casuarina 0811, Northern Territory, Australia, Telephone: 61-8-8922-8196, Fax: 61-8-8927-5187, E-mail: allenc{at}menzies.edu.au. Matthew O’Brien, St. Vincent’s and Geelong Clinical School, St. Vincent’s Hospital, Fitzroy 3065, Victoria, Australia, Telephone: 61-3-9288-2211.




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A. C. Cheng and B. J. Currie
Melioidosis: Epidemiology, Pathophysiology, and Management
Clin. Microbiol. Rev., April 1, 2005; 18(2): 383 - 416.
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