S. pneumoniae is one of the most common causes of paediatric bacterial pneumonia. In low-income countries such as Nepal, CRP level and blood culture can be useful in diagnosis assessment. We assessed the association between CRP/blood culture, and pneumonia with end-point consolidation.
We included children less than 5 years of age admitted with suspected pneumonia to Patan Hospital in 2018 and 2019, whose chest xray, CRP level and blood culture were done. CRP levels >40 mg/dl were considered elevated.
There was a significant difference (p<0.001) in CRP levels between EPC-pneumonia and non-EPC pneumonia cases with a median (IQR) CRP of 46.2 (16, 215) in 141 EPC-pneumonia cases and a median (IQR) CRP of 13 (4, 35) in non-EPC pneumonia cases. The sensitivity and specificity of CRP >40mg/dl to detect EPC pneumonia were 50% and 84% respectively. The area under the ROC curve was 0.727 indicating good discrimination between EPC-pneumonia and non-EPC pneumonia. Among the EPC-pneumonia cases, 62% had elevated CRP and 3.5% had S. pneumoniae positive blood cultures.
There was a significant association between CRP and EPC pneumonia. Blood culture had low sensitivity to detect bacterial pneumonia, nevertheless, CRP may be a useful tool in diagnosis of bacterial pneumonia.