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Objective To investigate the diagnostic value of blood routine and inflammatory factors in children with acute fever.Methods 137 children of acute fever were divided into infection group(including bacterial infection and non bacterial infection) and non infection group.And 50 healthy children(control group) were collected.Results were compared with blood routineand inflammatory factor.Results White blood cell(WBC),platelet(PLT) and neutrophil percentage(N％) were significantly increased in the bacterial infection group(P＜0.05),and there was significant difference between the control group,the non-infection group and the non-bacterial infection group(P＜0.05),and the percentage of PLT and N％ was statistically significant(P＜0.05) compared with non-infected group.The levels of interleukin(IL)-2 in the bacterial infection group were significantly lower than those in the nonbacterial infection group,the non-infection group and the control group(P＜0.05).The levels of IL-6,IL-10 and TNF-α in bacterial infection group were significantly higher than those in control group and non-infected group(P＜0.05).Misdiagnosis rate of inflammatory factors is the highest (18.25 ％),followed by blood 14.60％,and blood combined with inflammatory factors is the lowest (8.76 ％).Conclusion Blood combined with inflammatory factors can effectively reduce the misdiagnosis rate,the children with the blood unclear caused of should be combined with inflammatory factors detection in order to further clarify the cause and early treatment.
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Objective To investigate the diagnostic value of blood routine and inflammatory factors in children with acute fever.Methods 137 children of acute fever were divided into infection group(including bacterial infection and non bacterial infection) and non infection group.And 50 healthy children(control group) were collected.Results were compared with blood routineand inflammatory factor.Results White blood cell(WBC),platelet(PLT) and neutrophil percentage(N％) were significantly increased in the bacterial infection group(P＜0.05),and there was significant difference between the control group,the non-infection group and the non-bacterial infection group(P＜0.05),and the percentage of PLT and N％ was statistically significant(P＜0.05) compared with non-infected group.The levels of interleukin(IL)-2 in the bacterial infection group were significantly lower than those in the nonbacterial infection group,the non-infection group and the control group(P＜0.05).The levels of IL-6,IL-10 and TNF-α in bacterial infection group were significantly higher than those in control group and non-infected group(P＜0.05).Misdiagnosis rate of inflammatory factors is the highest (18.25 ％),followed by blood 14.60％,and blood combined with inflammatory factors is the lowest (8.76 ％).Conclusion Blood combined with inflammatory factors can effectively reduce the misdiagnosis rate,the children with the blood unclear caused of should be combined with inflammatory factors detection in order to further clarify the cause and early treatment.
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INTRODUCTION: During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. METHODS: Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. RESULTS: A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. DISCUSSION: Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well-planned and funded vaccination activities can prevent future CRS cases.
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OBJECTIVE: To identify the etiology and risk factors of undifferentiated fever in a cluster of patients in Western Province, Solomon Islands, May 2014. METHODS: An outbreak investigation with a case control study was conducted. A case was defined as an inpatient in one hospital in Western Province, Solomon Islands with high fever (> 38.5 °C) and a negative malaria microscopy test admitted between 1 and 31 May 2014. Asymptomatic controls matched with the cases residentially were recruited in a ratio of 1:2. Serum samples from the subjects were tested for rickettsial infections using indirect micro-immunofluorescence assay. RESULTS: Nine cases met the outbreak case definition. All cases were male. An eschar was noted in five cases (55%), and one developed pneumonitis. We did not identify any environmental factors associated with illness. Serum samples of all five follow-up cases (100%) had strong-positive IgG responses to scrub typhus. All but one control (10%) had a moderate response against scrub typhus. Four controls had low levels of antibodies against spotted fever group rickettsia, and only one had a low-level response to typhus group rickettsia. DISCUSSION: This outbreak represents the first laboratory-confirmed outbreak of scrub typhus in the Western Province of Solomon Islands. The results suggest that rickettsial infections are more common than currently recognized as a cause of an acute febrile illness. A revised clinical case definition for rickettsial infections and treatment guidelines were developed and shared with provincial health staff for better surveillance and response to future outbreaks of a similar kind.
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Objective To investigate the clinical value of serum procalcitonin (PCT) in the diagnosis and treatment of the patients with high fever of acute illness.Methods A total of 285 febrile patients suffered from acute illness were divided into the conventional group (n =122) and the PCT group (n =163).The routine blood examination and serum level of C-reactive protein (CRP) detection were carried out for the dignosis of these febrile patiens of two groups,and in addition,serum PCT determination was carried out in the patients of PCT group.The diagnosis was comnfirmed by etiology or immunologic assays.Routine guidelines of administrating antibiotics were used for treatment in the conventional group.Whereas the antibiotic therapy given to patients of PCT group was guided by the serum PCT levels.Two groups were compared in respect of the antibiotics costs,duration of treatment with antibiotics,percentage of patients treated with antibiotics,efficiency of antibiotics treatment and the mortality rate.The patients of PCT group were further divided as per inflammatory markers of bacterial infection into three subgroups,namely bacterial infection group,viral infection group and non-infection group.At last,the relationship between serum PCT level and the prognosis of patients was analyzed.Results The cost of antibiotics,percentage of patients treated with antibiotics,and course of antibiotics treatment were (Y) (3586.5 ± 703.3),95.08％ and (15.01 ± 11.21) days,respectively in conventional group,whereas (Y) (1871.2 ± 433.5),54.60％,(11.22 ±7.10) days in PCT group with statistically significant difference between two groups (P ＜ 0.01),but there were no significant differences in clinical efficiency and mortality between groups (P ＞ 0.05).Serum PCT (1.12 ± 0.88) ng/ml in bacterial infection group was higher than that in both virus infected group (0.21 ± 0.1 1) ng/ml and non-infected group (0.18 ± 0.13) ng/ml.There was no statistics difference in serum PCT level between virus infected group and non-infected group (P ＞ 0.05).The diagnosis of bacterial infection with serum PCT was better than other inflammatory markers because serum PCT had high sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV).Conclusions Serum PCT level was reliable to differentiate the nature of acute infection with high fever and to evaluate the prognosis by emergency physicians.There was an important significance for rational use of antibiotics by the guidance of PCT levels.