Mansour KM, Kuypers FA, Wang TN, Miller AM, Larkin SK, Morris CR. Secretory phospholipase A2: a marker of infection in febrile children presenting to a pediatric ED.
Am J Emerg Med 2010;
29:1163-8. [PMID:
20708879 DOI:
10.1016/j.ajem.2010.06.024]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 06/23/2010] [Accepted: 06/24/2010] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND
Fever is a common presenting complaint to the emergency department (ED), and the evaluation of the febrile child remains a challenging task.
OBJECTIVE
The aim of this study was to examine the relationship between secretory phospholipase A2 (sPLA2) and infection in febrile children.
METHODS
A prospective convenience sample of children presenting with fever to an urban pediatric ED were studied. Blood and urine cultures, a complete blood count, and serum concentrations of sPLA2 were obtained, and patients were compared based on their final diagnosis of either a viral or bacterial infection.
RESULTS
In the 76 patients enrolled, 60 were diagnosed with a viral infection, 14 with a bacterial infection, 1 with Kawasaki disease, and 1 with acute lymphoblastic leukemia. The difference in the serum concentration of sPLA2 in patients with viral infections (22 ± 34 ng/mL) versus those with bacterial infections (190 ± 179 ng/mL) was statistically significant (P < .0001). Receiver operator characteristic curve analysis revealed that sPLA2 was more accurate at predicting bacterial infection (area under the curve = 0.89) than the total white blood cell count (area under the curve = 0.71) and that a value of more than 20 ng/mL had a sensitivity of 93%, specificity of 67%, positive predictive value of 39%, and negative predictive value of 97%.
CONCLUSION
Secretory phospholipase A2 differs significantly in children with viral versus bacterial infection and seems to be a reliable screening test for bacterial infection in febrile children.
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