Abstract

Inflammatory markers are a subset of biomarkers that may help practitioners identify diseases earlier and more accurately. Establishing specific biomarker levels in healthy and sick patients may help differentiate sick children who require medical intervention from those who do not. These interventions can include surgical treatment or the decision to administer antibiotics. This review evaluates the literature on 4 biomarkers, including: (1) erythrocyte sedimentation rate, (2) C-reactive protein, (3) interleukin-6, and (4) procalcitonin, and reviews these biomarkers' diagnostic ability when applied to 4 common pediatric clinical scenarios, including: (1) acute meningitis, (2) serious bacterial infection, (3) appendicitis, and (4) septic arthritis. The results of major studies are presented, along with recommendations for the use of these biomarkers for diagnostic decision making regarding these clinical scenarios in the emergency department.

Keywords: C-reactive protein, CRP, erythrocyte sedimentation rate, ESR, procalcitonin, PCT, interleukin-6, IL-6, appendicitis, serious bacterial infection, SBI, meningitis, septic arthritis, pediatrics, children, meta-analysis, systematic review, and biomarkers