C-reactive protein in viral and bacterial gastroenteritis in childhood

To differentiate bacterial from viral infections the level of C-reactive protein in serum samples was studied in three groups of children under 5 years of age with gastroenteritis. Of the 53 children with bacterial infection, 41 (77%) had C-reactive protein levels greater than or equal to 12 mg l(-1), 32 (66%) greater than or equal to 20 mg l(-1) and 24 (45%) greater than or equal to 35 mg l(-1). Of the 35 patients with viral infection, 4 (11%) had C-reactive protein Levels > 12 mg l(-1), 3 (9%) greater than or equal to 20 mg l(-1) and 1(3%) greater than or equal to 35 mg l(-1). The best balance between sensitivity and specificity of C-reactive protein was obtained for a cut-off level greater than or equal to 12 mg l(-1) (sensitivity 77%, specificity 89%) as compared to > 20 mg l(-1) (sensitivity 58%, specificity 97%) and I 35 mg 1 (sensitivity 44%, specificity 97%). Our results suggest that the determination of C-reactive protein values may be a useful tool for predicting bacterial gastroenteritis in children.