ERYTHROCYTE SEDIMENTATION-RATE, WHITE BLOOD-CELL COUNT AND SERUM C-REACTIVE PROTEIN IN ASSESSING ETIOLOGIC DIAGNOSIS OF ACUTE LOWER RESPIRATORY-INFECTIONS IN CHILDREN

The clinical signs, symptoms and host responses (erythrocyte sedimenta tion rate, white blood cell count and C-reactive protein) were studied to distinguish bacterial from viral acute lower respiratory infection (ALRI) in 121 children hospitalized for ALRI. Etiologic diagnosis was based on blood culture, antibody assays and antigen detection, Childr en with bacterial involvement only were older than those with viral in volvement alone (mean, 5.1 vs. 2.5 years), and their duration of respi ratory symptoms had lasted longer (mean, 4.6 vs, 3.3 days). Children w ith unknown etiology had a shorter duration of fever before hospitaliz ation than those with etiology identified with the methods used (mean, 1.6 vs. 2.9 days). The host response ranged widely within etiologic g roups. The mean erythrocyte sedimentation rate did not differ signific antly between the bacterial and viral ALRI (38 vs. 28 mm/hour); neithe r did white blood cell count (13.2 vs. 13.6 x 10(9)/liter) or C-reacti ve protein (68 vs. 49 mg/liter). No combination of clinical signs and host responses or any cutoff values could be shown to differentiate re liably bacterial from viral ALRI.