Serial serum C-reactive protein to monitor recovery from acute hematogenous osteomyelitis in children

Pediatr Infect Dis J. 1995 Jan;14(1):40-4. doi: 10.1097/00006454-199501000-00008.


Serial C-reactive protein (CRP) and erythrocyte sedimentation rate determinations were compared with clinical course and outcome at 1 to 2 months in 63 children with acute hematogenous osteomyelitis. High CRP values (163 +/- 108 mg/liter) on admission began to descend after the second day of treatment. From the fourth day on higher (P = 0.03 to P = 0.0001) CRP values distinguished a complicated from an uneventful course of acute hematogenous osteomyelitis and the patients symptomatic at 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 identify the type of clinical course but higher values on Days 4 to 7 distinguished children symptomatic at follow-up (P = 0.02) from asymptomatic ones. Monitoring serial CRP values can alert the physician to complications and predict outcome earlier than clinical signs or roentgenograms.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Blood Sedimentation
  • C-Reactive Protein / analysis*
  • Child
  • Child, Preschool
  • Haemophilus influenzae
  • Humans
  • Osteomyelitis / blood
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / metabolism*
  • Osteomyelitis / microbiology
  • Radiography
  • Staphylococcus aureus
  • Streptococcus pyogenes


  • C-Reactive Protein