Elevated parathyroid hormone levels in association with rhabdomyosarcoma

Abstract

in one of our patients) may not be detected by any blood culture system i f a small volume of blood is sampled. It is likely that the four cases of pneumococcemia were detected only by routine cultures because the routine culture bottles received a larger inoculum of blood than did the quantitative plates. In our small series, colony counts were not helpful in predicting which children with occult pneumococcal bacteremia would develop sustained bacteremia or focal complications. Of the five patients with occult bacteremia, the two with 0.5 and 200 cfu/ml, respectively, subsequently developed bilateral otitis, the patient with 8 cfu/ml developed otitis and sustained bacteremia, the patient with 10 cfu /ml developed otitis and pneumonia , and the patient with 60 cfu /ml recovered uneventfully without developing focal complications. In summary; quantitative blood cultures are a sensitive technique for the early detection of childhood bacteremia. The low number of pneumococci found in the blood of some children suggests that pneumococcemia may be missed if small volumes of blood are cultured.