1921
Volume 70, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Previous work suggested that C-reactive protein (CRP) may be a useful test in the diagnosis of melioidosis, the infection caused by . 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.

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References

  1. White NJ, 2003. Melioidosis. Lancet 361 : 1715–1722. [Google Scholar]
  2. Reny J, Vuagnat A, Ract C, Benoit M, Safar M, Fagon J, 2002. Diagnosis and follow-up of infections in intensive care patients: value of C-reactive protein compared with other clinical and biological variables. Crit Care Med 30 : 529–535. [Google Scholar]
  3. Povoa P, 2002. C-reactive protein: a valuable marker of sepsis. Intensive Care Med 28 : 235–243. [Google Scholar]
  4. van Leeuwen MA, van der Heijde DM, van Rijswijk MH, Houtman PM, van Riel PL, van de Putte LB, Limburg PC, 1994. Interrelationship of outcome measures and process variables in early rheumatoid arthritis. A comparison of radiologic damage, physical disability, joint counts, and acute phase reactants. J Rheumatol 21 : 425–429. [Google Scholar]
  5. Ashdown LR, 1992. Serial serum C-reactive protein levels as an aid to the management of melioidosis. Am J Trop Med Hyg 46 : 151–157. [Google Scholar]
  6. Currie BJ, Fisher DA, Howard DM, Burrow JN, Lo D, Selva-Nayagam S, Anstey NM, Huffam SE, Snelling PL, Marks PJ, Stephens DP, Lum GD, Jacups SP, Krause VL, 2000. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 31 : 981–986. [Google Scholar]
  7. ACCP/SCCM, 1992. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20 : 864–874. [Google Scholar]
  8. Hopstaken RM, Muris JW, Knottnerus JA, Kester AD, Rinkens PE, Dinant GJ, 2003. Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection. Br J Gen Pract 53 : 358–364. [Google Scholar]
  9. Smith MD, Suputtamongkol Y, Chaowagul W, Assicot M, Bohuon C, Petitjean S, White NJ, 1995. Elevated serum procalcitonin levels in patients with melioidosis. Clin Infect Dis 20 : 641–645. [Google Scholar]
  10. Prat C, Dominguez J, Rodrigo C, Gimenez M, Azuara M, Jimenez O, Gali N, Ausina V, Resch B, Gusenleitner W, Muller WD, Luzzani A, Polati E, Dorizzi R, Rungatscher A, Pavan R, Merlini A, 2003. Procalcitonin, C-reactive protein and leukocyte count in children with lower respiratory tract infection. Pediatr Infect Dis J 22 : 963–968. [Google Scholar]
  11. Resch B, Gusenleitner W, Muller WD, Luzzani A, Polati E, Dorizzi R, Rungatscher A, Pavan R, Merlini A, 2003. Procalcitonin and interleukin-6 in the diagnosis of early-onset sepsis of the neonate. Acta Paediatr 92 : 243–245. [Google Scholar]
  12. Luzzani A, Polati E, Dorizzi R, Rungatscher A, Pavan R, Merlini A, 2003. Comparison of procalcitonin and C-reactive protein as markers of sepsis. Crit Care Med 31 : 1737–1741. [Google Scholar]
  13. Friedland JS, Suputtamongkol Y, Remick DG, Chaowagul W, Strieter RM, Kunkel SL, White NJ, Griffin GE, 1992. Prolonged elevation of interleukin-8 and interleukin-6 concentrations in plasma and of leukocyte interleukin-8 mRNA levels during septicemic and localized Pseudomonas pseudomallei infection. Infect Immun 60 : 2402–2408. [Google Scholar]
  14. Simpson AJ, Smith MD, Weverling GJ, Suputtamongkol Y, Angus BJ, Chaowagul W, White NJ, van Deventer SJ, Prins JM, 2000. Prognostic value of cytokine concentrations (tumor necrosis factor- alpha, interleukin-6, and interleukin-10) and clinical parameters in severe melioidosis. J Infect Dis 181 : 621–625. [Google Scholar]
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  • Received : 27 Aug 2003
  • Accepted : 19 Jan 2004

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