C-reactive protein levels in community-acquired pneumonia

Abstract

The diagnostic value of C-reactive protein (CRP) admission serum levels as an indicator of the aetiology of community-acquired pneumonia (CAP) was evaluated.A cohort of 1,222 patients with CAP was assessed. CRP levels were analysed in 258 patients with a single aetiological diagnosis. -1 in groups IV-V. A cut-off point of 25 mg?dL -1 had a sensibility, specificity, positive predictive value and negative predictive value of 0.6, 0.83, 0.3, and 0.94, respectively. After controlling for age and PORT score, the odds of having a CRP level w25 mg?dL -1 was 6.9 times higher in patients with L. pneumophila pneumonia than in those with non-L. pneumophila pneumonia.Patients with Legionella pneumophila pneumonia had higher C-reactive protein levels than those with pneumonia of any other aetiology, independently of severity of infection. Being a cheap and readily available test, C-reactive protein may be a useful adjunctive procedure in the diagnosis of community-acquired pneumonia. Eur Respir J 2003; 21: 702-705.

Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review

“…Of the studies dealing with our second research question, most deal with children, although five of them assessed adults 34 43 44 47 49. Two studies were conducted in a mixed primary and secondary care population34 45; all others included secondary care populations.…”

“…Four authors were not able to provide additional data, because these data were not available any more 43 44 47 49. One did not respond 50…”

“…None of the studies met all of Lijmer's criteria and six of eight studies concerned children, mostly in a secondary care environment. Unfortunately useful quantitative data were lacking in four studies of adults 43 44 47 50…”

Aetiology, outcomes & predictors of mortality in acute respiratory distress syndrome from a tertiary care centre in north India

“…One possible explanation for the relatively high mortality noted in the current study could be small number of ARDS cases with extrapulmonary causes such as trauma, poisoning, pancreatitis, burns, etc . in which mortality is usually low23. Also, there could be a selection bias in the ICU admission policy of hospitals in resource-limited countries where only the most sick patients are admitted to the ICU because of limited availability of ICU beds.…”

BTS guidelines for the management of community acquired pneumonia in adults: update 2009

“…With regard to predicting the microbial aetiology of CAP, higher CRP levels have been associated with pneumococcal pneumonia (especially if complicated by bacteraemia) compared with mycoplasma or viral pneumonias,189 [III] and in legionella pneumonia compared with all other identified single aetiologies 190 . [II] …”