C-REACTIVE PROTEIN IN THE DIAGNOSIS AND MANAGEMENT OF INFECTIONS IN GRANULOCYTOPENIC AND NON-GRANULOCYTOPENIC PATIENTS

The serum levels of C-reactive protein (CRP) were assayed in 64 non-granulocytopenic and 35 granulocytopenic patients with or without fever and infection. Most patients showed a direct CRP response within 24 hours after onset of fever (95% of non-granulocytopenic patients, 100% of granulocytopenic patients). The mean peak level of CRP in febrile patients with septicemia was 207 mg/l (median 214 mg/l) in non-granulocytopenic patients and 173 mg/l (median 168 mg/l) in granulocytopenic patients, and differed significantly (p < 0.001) from that in febrile patients without positive blood cultures. A significant difference between patients with major and minor infections was also found (p < 0.01). No significant difference in the CRP level was found between patients with microbiologically and clinically documented infections (p > 0.05, nor did the serum CRP levels differ between patients with infections due to gram-positive and gram-negative organisms. The most favorable cut-off limit for detection of an inflammatory process in this study was 25 mg/l. There was no quantitative difference between CRP levels measured by a latex-agglutination method and the nephelometry assay.