Is CRP useful alone to support the hypotesis of a bacteremia?

Clinical Scenario

It’s a very cold February, but ED is very hot in every sense of the word. 

A 22 y/o student refers stomach pain, chills, fever and diffuse muscolar pain. He has fever (38° C) there is a mild diffuse abdominal pain. 

The CRP value is 30 mg/L. 

Are there flu symptoms, or it is a bacteremia?

Can we use the CRP test for change our clinical suspicion? 

Conclusion 

CRP is the most used biomarker of infections. 

Last year we saw that a normal CRP doesn’t esclude an abdominal positive CT.   

News under the sun? No!

We can’t consider alone a normal CRP like a marker for rule out a bacteriaemia. At the same time an elevated CRP is not useful alone to prescribe antibiotic therapy. 

  

Bibliography 

NG Adams

Diagnostic use of C-reactive protein in bacteraemic emergency department patients.

Emerg Med Austral 2005 17, 371-5.

JL Vincent

Biomarkers in the critically ill patient: C-reactive protein.

Crit Care Clin  2011 27  241-251

YE Ha

Usefulness of C-Reactive Protein for evaluating clinical outcomes in cirrhotic patients with bacteremia.

Kor J Intern Med june 2011 26 (2) 195-200

Ciro Paolillo