White blood cell count and eosinopenia as valuable tools for the diagnosis of bacterial infections in the ED
| Autor: | François Lefebvre, Pierrick Le Borgne, Julia Chevrolet-Lavoignet, Charles Eric Lavoignet, Luc Sengler, Joffrey Bidoire, Pascal Bilbault, Sylvie Chabrier, Rania Jebri, Hakim Slimani |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Biliary Tract Diseases 030106 microbiology Prostatitis Sensitivity and Specificity Severity of Illness Index Sepsis Leukocyte Count 03 medical and health sciences 0302 clinical medicine Medical microbiology Internal medicine White blood cell medicine Humans Eosinopenia 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over business.industry Bacterial Infections General Medicine Middle Aged medicine.disease Appendicitis Eosinophils Pneumonia C-Reactive Protein Infectious Diseases medicine.anatomical_structure Urinary Tract Infections Cholecystitis Female Emergency Service Hospital business |
| Zdroj: | European Journal of Clinical Microbiology & Infectious Diseases. 38:1523-1532 |
| ISSN: | 1435-4373 0934-9723 |
| DOI: | 10.1007/s10096-019-03583-2 |
| Popis: | Identifying an infection may be difficult in the ED. Neutrophilic leukocytosis is often used in the diagnosis of infection despite its lack of specificity in situations of stress. Our objective was to study the value of each parameter of the WBC count, in particular eosinopenia, to diagnose bacterial infections in the ED. We conducted a retrospective and observational study over a period of 6 months. All patients with one of the following diagnoses were eligible: pneumonia (9.9%), pyelonephritis (26.2%), prostatitis (8.4%), appendicitis (26.2%), cholecystitis (8.4%), and diverticular sigmoiditis (5%). A total of 466 infected patients were included for statistical analysis, and a control group of 466 uninfected patients was randomly selected in the same period of time. All leukocyte count parameters were significantly modified (p 0.001) in the infected group compared with the control group. Neutrophils and total leukocytes remain the two most suitable parameters for the diagnosis of infections in the ED. Eosinopenia represented the most efficient parameter of the WBC count for the diagnosis of urinary and biliary tract infections. Deep eosinopenia presented a specificity of 94% for the diagnosis of infection. Any modification of the WBC count associated with an elevation of CRP ( 40 mg/L) or fever ( 38.5 °C) showed a high specificity for the diagnosis of infection. A careful analysis of the WBC count remains a valuable tool for the diagnosis of infection in the ED. |
| Databáze: | OpenAIRE |
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