Archives of Disease in Childhood 2008;93:628-631
Archimedes
Question 1
DIAGNOSTIC UTILITY OF RAPID IMMUNOCHROMATOGRAPHIC URINE ANTIGEN TESTING IN SUSPECTED PNEUMOCOCCAL INFECTIONS
1 James Paget University Hospitals NHS Foundation Trust, Gorleston, Great Yarmouth NR31 6LA, UK; anjayma@gmail.com
2 St George’s Hospital, London, UK
| The first 150 words of the full text of this article appear below. |
A 9-month old infant has been admitted with fever, cough, shortness of breath and poor feeding. He is tachypnoeic with bilateral crackles and occasional rhonchi. Initial management is started with a provisional diagnosis of bronchiolitis. Nasopharyngeal aspirate for respiratory syncytial virus turns out to be negative. Over the next few hours, he is noted to have high grade pyrexia with a gradual clinical deterioration. As the on-call specialist registrar in paediatrics, you are now worried about a possible bacterial aetiology. You decide to commence antibiotics after sending a sample for blood culture. A chest radiograph, full blood count and C-reactive protein level do not help to distinguish between a viral versus bacterial infection. You are aware that in an infant with bacterial pneumonia, the most common causative organism is Streptococcus pneumoniae. A colleague informs you that your hospital laboratory can perform a rapid immunochromatographic urine antigen detection test
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