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How useful is C-reactive protein in detecting occult bacterial infection in young children with fever without apparent focus?
  1. Nitin Maheshwari
  1. SpR (Paediatrics), Oxford Deanery; nitin023@rediffmail.com

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You are a specialist registrar in a paediatric day assessment unit and often see young children with high fever but no obvious focus of infection on physical examination. You wonder if a screening test can be done in such patients to identify those with occult bacterial infection. You know that in some units C-reactive protein (CRP) is measured routinely in all children with high fever. However, you are not sure if CRP measurement is a good screening test to detect occult bacterial infection in a young child with fever without apparent focus. You decide to find out more.

Structured clinical question

In young children with fever without apparent focus on physical examination and history [subject], is measurement of C-reactive protein a good screening test [intervention] to detect occult bacterial infection or bacteraemia [outcome]?

Search strategy and outcome

See table 1.

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Table 1

 C-reactive protein in young children with fever without apparent focus

Primary sources

Medline (1951–2004) via Dialog DATA star: “C-reactive protein or acute phase reactant$ or acute phase protein$ or CRP AND fever without focus or fever of unknown …

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