In a prospective study, 330 consecutive children less than 24 months old coming to the emergency room of Yale-New Haven Hospital with a temperature ≥ 40 C were evaluated. Nearly all patients had a white blood cell (WBC) count, erythrocyte sedimentation rate (ESR) (Wintrobe), blood culture, and chest roentgenogram. Eighty-eight percent were evaluated 24 to 48 hours later. The mean WBC count and ESR were significantly elevated in children with positive blood cultures or pneumonia. The risk of bacteremia was increased threefold and the risk of pneumonia was increased twofold in children with a WBC count ≥ 15,000/ cu mm or an ESR ≥ 30 mm/hr compared to children without leukocytosis or elevated ESR. Sixty-one percent of children with bacteremia or pneumonia, 63% of children in whom these diagnoses were not apparent on physical examination, and 86% of children with otitis media complicated by pneumonia or bacteremia had either a WBC count ≥ 15,000/cu mm or an ESR ≥ 30 mm/hr. A WBC count ≥ 15,000/cu mm and an ESR ≥ 30 mm/hr were more effective than a polymorphonuclear leukocyte count ≥ 10,000/cu mm and/or a band count ≥ 500/cu mm in screening young children with high fever for bacteremia, pneunlonia, or complicated otitis media.
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机译：在一项前瞻性研究中，评估了330名连续不到24个月的儿童，他们来到耶鲁-纽黑文医院的急诊室，体温≥40℃。几乎所有患者均具有白细胞（WBC）计数，红细胞沉降率（ESR）（Wintrobe），血液培养和胸部X线检查。 24至48小时后评估了88％。血培养呈阳性或肺炎的儿童的平均白细胞计数和ESR显着升高。与无白细胞增多症或ESR升高的儿童相比，WBC计数≥15,000 / cu mm或ESR≥30 mm / hr的儿童发生菌血症的风险增加了三倍，肺炎的风险增加了两倍。 61％的菌血症或肺炎患儿，63％的身体检查未明确诊断的患儿以及86％的中耳炎并发肺炎或菌血症的孩子的WBC≥15,000 / cu mm或ESR≥30毫米/小时。在筛查高热幼儿菌血症时，WBC≥15,000 / cu mm和ESR≥30 mm / hr比多形核白细胞计数≥10,000 / cu mm和/或谱带计数≥500 / cu mm更有效，肺炎或复杂的中耳炎。
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