Objective. The aim of this prospective study was to compare the clinical value of the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) count in diagnosis and follow-up of acute hematogenous osteomyelitis in children.Design. Forty-four children aged 2 weeks to 14 years with bacteriologically confirmed acute hematogenous osteomyelitis were examined. Staphylococcus aureus was responsible in 39 cases (89%), Haemophilus influenzae type b in 3 cases (7%), pneumococcus in 1 case (2%), and a microaerophilic streptococcus in 1 case (2%). ESR was measured at the time of admission and on days 3, 5, 7, 10, 14, 19, and 29 of treatment, and CRP was measured on the same days as ESR but also on days 2, 9, 12, 17, and 23. WBC count was examined at the time of admission and on days 5, 10, 19, and 29.Results. ESR was elevated (≥20 mm/h) initially in 92% of the cases; the mean value was 45 mm/h, and the peak values (mean 58 mm/h) were reached on days 3 to 5. After this the levels slowly returned to normal in approximately 3 weeks (mean 18 days). CRP was elevated (19 mg/L) at the time of admission in 98% of the cases, the mean value being 71 mg/L. The peak CRP value was reached on day 2 (mean 83 mg/L). The decrease was very rapid, normal values being reached within a week (mean 6.9 days). The WBC count was a poor indicator of acute hematogenous osteomyelitis, since only 35% of the children had leukocytosis (WBCs 12 x 109/L) at the time of admission.Conclusions. In patients with acute hematogenous osteomyelitis, CRP increased and especially decreased significantly faster than ESR, reflecting the effectiveness of the therapy given and predicting recovery more sensitively than ESR or WBC count.
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机译：目的。这项前瞻性研究的目的是比较红细胞沉降率（ESR），C反应蛋白（CRP）和白细胞（WBC）计数在儿童急性血源性骨髓炎的诊断和随访中的临床价值。设计。检查了2个2周至14岁的细菌学确诊的急性血源性骨髓炎的儿童。金黄色葡萄球菌负责39例（89％），b型流感嗜血杆菌3例（7％），肺炎球菌1例（2％），微需氧链球菌1例（2％）。在入院时和治疗的第3、5、7、10、14、19和29天测量ESR，并在与ESR相同的天数以及在第2、9、12、17天测量CRP。 23.在入院时以及第5、10、19和29天检查白细胞计数。最初有92％的病例ESR升高（≥20 mm / h）;平均值为45 mm / h，并在第3至5天达到峰值（平均58 mm / h）。此后，水平在大约3周（平均18天）内缓慢恢复正常。 98％的患者入院时CRP升高（> 19 mg / L），平均值为71 mg / L。第2天达到了CRP峰值（平均83 mg / L）。下降非常迅速，一周内（平均6.9天）达到了正常值。由于入院时只有35％的儿童患有白细胞增多症（WBC> 12 x 109 / L），因此WBC计数不能很好地指示急性血源性骨髓炎。在急性血源性骨髓炎患者中，CRP升高，尤其是下降的速度明显快于ESR，这反映了所给予治疗的有效性，并且预测恢复比ESR或WBC计数更为敏感。
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