ArticlePloS one2022
Differentiating between bacterial and viral infections by estimated CRP velocity.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- A systematic review and meta-analysis on diagnostic accuracy of point-of-care C-reactive protein devices for acute respiratory tract infections.Infection · 2026Pooled it
- Inflammatory Biomarkers Following Orthopedic Surgery: Current Evidence, Clinical Applications, and Future Perspectives-A Narrative Review.Journal of clinical medicine · 2026Review
- Clinical profile and risk factors of severe adenoviral infections among hospitalised children in South India: a cross-sectional study.BMJ paediatrics open · 2026Article
- The accuracy of CRP to detect bacteraemia in Malawian children.BMC infectious diseases · 2026Article
- C-Reactive Protein Trajectories by Summary Metric Across the Coronavirus-2019 Period: A 16-Year Interrupted Time-Series Analysis (2008-2023).Diagnostics (Basel, Switzerland) · 2026Article
- Early signaling of inflammatory bursts by using estimated C-reactive Protein velocity (eCRPv): a model of acute meningitis and iso-CRPinemia.BMC infectious diseases · 2026Article
- Prolonged transaminitis in typhoid hepatitis: a rare case report with a diagnostic dilemma from Nepal.Annals of medicine and surgery (2012) · 2026Article
- Pathogen Evasion of Humoral Innate Immunity: Coping with C-Reactive Protein and Serum Amyloid A.International journal of molecular sciences · 2026Review
- Exploration of the correlation between clinical indicators and prognosis in hospitalized children with pneumonia and construction of a risk prediction model based on machine learning algorithms.Frontiers in medicine · 2026Article
- Identifying the thresholds of C-reactive protein, procalcitonin, and interleukin-6 among children ≤36 months' old with fever without source at risk of serious bacterial infections: a systematic review and meta-analysis.Frontiers in pediatrics · 2026Review
- Article
- Determining the Use and Reasons for Non-De-Escalation of Empiric Carbapenem Therapy in a Private Hospital in South Africa.Antibiotics (Basel, Switzerland) · 2025Article
- C-reactive protein velocity and inflammatory burden index: new systemic inflammatory biomarkers and their predictive value for the latent period in preterm premature rupture of membrane pregnancies.Archives of gynecology and obstetrics · 2025Article
- Characterizing CRP dynamics during acute infections.Infection · 2025Article
- The value of common blood parameters for the differential diagnosis of respiratory tract infections in children.AMB Express · 2025Article
- Comparative analysis of blood routine, C-reactive protein, and biochemical markers in children withFrontiers in pediatrics · 2025Article
- Harnessing the host response for precision infectious disease diagnosis.Clinical microbiology reviews · 2024Review
- Quantitative Evaluation of Microcirculatory Alterations in Patients with COVID-19 and Bacterial Septic Shock through Remote Photoplethysmography and Automated Capillary Refill Time Analysis.Medicina (Kaunas, Lithuania) · 2024Article
- Sepsis Biomarkers: Advancements and Clinical Applications-A Narrative Review.International journal of molecular sciences · 2024Review
- Estimated C-reactive protein (CRP) velocity for rapidly distinguishing bacterial from other etiologies in children presenting to emergency department with remarkably elevated CRP levels.European journal of pediatrics · 2024Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDifferentiating between acute viral and bacterial infection is challenging due to the similarity in symptom presentation. Blood tests can assist in the diagnosis, but they reflect the immediate status and fail to consider the dynamics of an inflammatory response with time since symptom onset. We applied estimated C-reactive protein (CRP) velocity (eCRPv), as derived from the admission CRP level divided by time from symptom onset, in order to better distinguish between viral and bacterial infections.
methodsThis cross-sectional study included patients admitted to the emergency department with a confirmed viral (n = 83) or bacterial (n = 181) infection. eCRPv was defined as the ratio between the absolute CRP level upon admission to time from symptom onset (in hours). Absolute CRP and eCRPv values were compared between the 3 groups.
resultsBacterial patients presented with higher CRP levels (133 mg/L) upon admission compared to viral patients (23.31 mg/L) (P < 0.001). Their median value of eCRPv velocity was 4 times higher compared to the viral patients (1.1 mg/L/h compared 0.25 mg/L/h, P < 0.001). Moreover, in intermediate values of CRP (100-150 mg/L) upon admission, in which the differential diagnosis is controversial, high eCRPv is indicative of bacterial infection, eCRPv >4 mg/L/h represents only bacterial patients.
conclusionsDuring an acute febrile illness, the eCRPv value can be used for rapid differentiation between bacterial and viral infection, especially in patients with high CRP values. This capability can potentially expedite the provision of appropriate therapeutic management. Further research and validation may open new applications of the kinetics of inflammation for rapid diagnosis of an infectious vs. a viral source of fever.
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