Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children

Xin Zhang,Yang Li,Lanfang Min

doi:10.1186/s12890-021-01756-4

Abstract

BackgroundThere is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI.Methods108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared.ResultsThe levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively.ConclusionsPCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

Highlights

There is a lack of studies comparing PCT, C-reactive protein (CRP) and White blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections
Pneumonia caused by the acute respiratory tract infections (ARTI) in children has acute onset, rapid development and high mortality
The diagnostic criteria are mainly based on the handbook: Integrated Management of Childhood Illness by World Health Organization [9]. 108 children with bacteria detected by sputum culture were treated as group A, 61 males and 47 females, age (2.84 ± 3.30) years old. 116 children with common respiratory virus detected by serological test were treated as group B, 54 males and 62 females, age (4.08 ± 3.28) years old. 122 children with Mycoplasma pneumoniae detected by serological test were treated as group C, 54 males and 68 females, age (4.04 ± 3.14) years old

Summary

Introduction

There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. Pneumonia caused by the acute respiratory tract infections (ARTI) in children has acute onset, rapid development and high mortality. It is the disease with the highest hospitalization rate and mortality of children under 5 years old [1]. Inflammatory indicators such as Procalcitonin (PCT) and C-reactive protein (CRP) have received more and more attention in the field of differential diagnosis of ARTI [4, 5]. There are some studies on above indicators as infection markers, the comparative analysis of PCT, CRP and WBC among patients with bacterial, viral and mycoplasmal ARTI is rare

Methods

Results

Conclusion