The Usefulness of The Usefulness of C-Reactive Protein Level in the management of acute haematogenous osteomyelitis in children

C-Reactive Protein Level in the management

  • IMJ Iraqi Medical Journal
Keywords: Reactive Protein ( CRP ),


Background: C- Reactive Protein (CRP ) is an acute phase protein synthesized by the liver in response to acute bacterial infection and tissue necrosis. Acute osteomyelitis in children is a common disease in Iraq especially in the rural areas. Late presentation and diagnosis of  this disease leads to difficult treatment and complications especially chronic osteomyelitis.
Objective: To prove that CRP is better than Erythrocyte Sedimentation Rate  (ESR) and White Blood Cells (WBC) in the diagnosis and follow up of patients of acute haematogenous osteomyelitis in children.
Methods: Thirty two children who had an acute haematogenous osteomyelitis confirmed by bacteriological examination were admitted in the Baqouba General Hospital from Feb. 2005 to Dec. 2006.   Four patients who presented very early were treated conservatively, while the other 28 were treated surgically. In addition to other investigations done, the CRP level was also done to all patients at the time of admission, 3 days after and at the time of discharge.
Results: The changes in the level of CRP were compared with the changes of  ESR and WBC. The author found that the CRP increased rapidly in response to bacterial osteomyelitis and also decreased rapidly in response to the treatment while the ESR and WBC increased slowly in response to osteomyelitis and also decreased slowly after  infection subsided  in response to treatment.
Conclusion: The CRP is more useful in the diagnosis, follow up and treatment of acute osteomyelitis than ESR and WBC. The CRP is sensitive and  more specific than ESR and  WBC as well as it is  useful in changing the intravenous antibiotics (i.v.) to oral in acute haematogenous osteomyelitis in children.       
Keywords:  C- Reactive Protein ( CRP ), Version:1.0 StartHTML:000000230 EndHTML:000001491 StartFragment:000001429 EndFragment:000001455 StartSelection:000001429 EndSelection:000001455 SourceURL:

Reactive Protein ( CRP ),

(ESR), White Blood Cells count ( WBC ), Magnetic Resonance Imaging ( MRI ).



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