SERIAL SERUM C-REACTIVE PROTEIN TO MONITOR RECOVERY FROM ACUTE HEMATOGENOUS OSTEOMYELITIS IN CHILDREN

Serial C-reactive protein (CRP) and erythrocyte sedimentation rate det erminations were compared with clinical course and outcome at 1 to 2 m onths in 63 children with acute hematogenous osteomyelitis. High CRP v alues (163 +/- 108 mg/liter) on admission began to descend after the s econd day of treatment. From the fourth day on higher (P = 0.03 to P = 0.0001) CRP values distinguished a complicated from an uneventful cou rse of acute hematogenous osteomyelitis and the patients symptomatic a t follow-up (P = 0.003 to P = 0.0001) from asymptomatic ones. Children who developed extensive radiographic changes had elevated CRP values for a longer time (32 +/- 13 days) than children with typical changes (11 +/- 6 days, P = 0.0001). Erythrocyte sedimentation rates did not i dentify the type of clinical course but higher values on Days 4 to 7 d istinguished children symptomatic at follow-up (P = 0.02) from asympto matic ones. Monitoring serial CRP values can alert the physician to co mplications and predict outcome earlier than clinical signs or roentge nograms.