C-REACTIVE PROTEIN IN VIRAL AND BACTERIAL INFECTIONS

Abstract

Determination of serum C-reactive protein (CRP) has been suggested to be helpful in distinguishing bacterial from viral infections. We studied CRP in 176 children with respiratory virus infection and 97 children with bacterial or probable bacterial infection. Thirty-eight percent of the children with adenovirus infection (n=58), 20% with influenza (n=15), none with parainfluenza (n=26) and 13% with RSV infection (n=77) had CRP more than 40 mg/l. The mean CRP (±SD) values were 41±48 mg/l, 23±24 mg/l, 10±10 mg/l and 17±25 mg/l, respectively. In 29 viral pneumonias the mean CRP was 41±48 mg/l. Whereas 22 children with bacterial type pneumonia (lobar infiltrates and good clinical response to antibiotic therapy within 12 - 24 hours) had the mean CRP 133±61 mg/l. If the duration of symptoms was more than 12 hours all 39 children with septic infection and 78% of 36 children with urinary tract infection had CRP more than 40 mg/l. The mean CRP values were 115±71 mg/l and 89±61 mg/l, respectively. In conclusion, elevated CRP values (> 40 mg/l) are typical for bacterial infections, but may also be recorded in some viral infections.