C-REACTIVE PROTEIN IS MORE SENSITIVE THAN ERYTHROCYTE SEDIMENTATION-RATE FOR DIAGNOSIS OF INFECTIVE ENDOCARDITIS

The objective of this study was to evaluate the sensitivity of C-react ive protein (CRP) elevation compared to erythrocyte sedimentation rate (ESR), leucocyte count and thrombocyte count in the diagnosis of infe ctive endocarditis (IE). It was designed as a prospective study of sus pected episodes of IE in adults in tertiary care at a university-affil iate department of infectious diseases. In 89 episodes of IE, CRP was available from the start of treatment, Median age was 66 years, 45 wer e men and 44 women. Median CRP concentration was found to be 90 (range 0-357) mg/l with only 4% normal values. Episodes involving native val ves had higher CRP than episodes occurring,vith prosthetic valves, Sta phylococcal origin, short duration of symptoms, short duration of feve r and highest recorded temperature all correlated to higher CRP levels , The CRP response was also prominent among patients > 70 years old. A mong non-responders, a few cases,vith simultaneous cirrhosis were note d. ESR was less sensitive than CRP, with a normal level in 28% of the episodes. It was concluded that CRP determination is superior to eryth rocyte sedimentation rate, leucocyte count and thrombocyte count in th e diagnosis of infective endocarditis.