Infective endocarditis: C-reactive protein was more sensitive than ESR.

Clinical bottom line (level 4)

  1. More patients with infective endocarditis had a raised C-reactive protein than had a raised erythrocyte sedimentation rate.
Hogevik et al: Infection 1997; 25 (2): 82-85
Expires July 2003

The study

Setting: infectious diseases department, university hospital, Sweden

- patients (aged range 19 to 88 years; median 66, 51% male) with 89 episodes of infective endocarditis (diagnosed using modified von Reyn criteria)
antibiotic treatment
?independent ?blinded reference standard, applied in ?all patients from a ?consecutive inappropriate spectrum.
Diagnostic test: measured within 3 days from initiation of antibiotic treatment for infective endocarditis
  • C-reactive protein elevated
  • ESR elevated

The evidence


diagnostic test number of patients sensitivity for
infective endocarditis
(95% CI)		 LR+ LR-
CRP elevated 85 96%
(91% to 100%)
ESR elevated 80 72%
(64% to 81%)
total

  • Median CRP concentration was 90 (range 0-357) mg/l.

Comments

  1. As no information available on patients with possible or rejected infective endocarditis means this study provides no useful information on diagnosing infective endocarditis.

Citation

  1. Hogevik H, Olaison L, Anderson R, et al: C-reactive protein is more sensitive than erythrocyte sedimentation rate for diagnosis of infective endocarditis. Infection 1997; 25 (2): 82-85
Search Terms: explode 'infective and endocarditis' and CRP
Contributor: Carl Heneghan, Sumit Dhingra and Chris Ball, July 2000
Reviewer:

Clinical Question.
Patient suspected endocarditis
Intervention or Exposure ESR
Comparison CRP
Outcome diagnosis of endocarditis