The Utility of Platelet Count as a Potential Predictor of Infant Bacterial Infection

 

The evaluation of an infant with febrile illness and no obvious focus of infection is one of the main challenging job that faces pediatricians. The general condition of the infant can generally be deceptive, and is labeled Serious Bacterial Infection (SBI). Laboratory markers that have been used to predict SBI include raised white blood cell (WBC) counts, C-reactive protein, pro-calcitonin and even interleukin-6 levels. White blood cell count by itself, does not compare well with relatively more recent markers such as C-reactive protein and pro-calcitonin.

A new study revises the relationship between reactive thrombocytosis among febrile infants and assesses the utility of platelet count as a potential predictor of serious bacterial infection in these patients.

The mean platelet count in SBI infants was observed to be significantly higher than non-SBI infants. Infections of the respiratory, urinary and gastrointestinal tracts, as well as bones and meninges were the most common causes of reactive thrombocytosis.  A platelet count of > 45,000/mL in addition to other laboratory data such as WBC> 15,000 mL and CRP ≥2mg/dL was a strong indicator of SBI.

The study asserts the addition of a routine hematology parameter like platelet count to the sepsis screen results in better differentiating between SBI and non-SBI infants, which delineates the severity of the infection and the extent of the treatment. This finding might be useful in the ER  and in pediatrics where quick turnaround time is necessary. 

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