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Copyright ©ERS Journals Ltd 2003
C-reactive protein levels in community-acquired pneumonia
Depts of 1 Infectious Diseases, 2 Microbiology, 3 Respiratory Diseases, Hospital Clinic, Barcelona, Spain
CORRESPONDENCE: E. García Vázquez, Servicio de Infecciones, Hospital Clínic, C/Villarroel 170 , 08036, Barcelona, Spain. Fax: 34 934514438. E-mail: egarciav@clinic.ub.es
Keywords: aetiology, C-reactive protein, community acquired pneumonia, diagnosis, Legionella pneumophila
Received: August 29, 2002
Accepted October 24, 2002
The diagnostic value of C-reactive protein (CRP) admission serum levels as an indicator of the aetiology of community-acquired pneumonia (CAP) was evaluated.
A cohort of 1,222 patients with CAP was assessed. CRP levels were analysed in 258 patients with a single aetiological diagnosis.
The mean CRP values in patients with pyogenic, atypical, viral and Legionella pneumophila pneumonia were: 16 mg·dL–1, 13 mg·dL–1, 14 mg·dL–1 and 25 mg·dL–1, respectively. CRP levels were not significantly different among patients outcome research team (PORT) groups (19 mg·dL–1 in groups I–II, 16 mg·dL–1 in group III and 16 mg·dL–1 in groups IV–V. A cut-off point of 25 mg·dL–1 had a sensibility, specificity, positive predictive value and negative predictive value of 0.6, 0.83, 0.3, and 0.94, respectively. After controlling for age and PORT score, the odds of having a CRP level >25 mg·dL–1 was 6.9 times higher in patients with L. pneumophila pneumonia than in those with non-L. pneumophila pneumonia.
Patients with Legionella pneumophila pneumonia had higher C-reactive protein levels than those with pneumonia of any other aetiology, independently of severity of infection. Being a cheap and readily available test, C-reactive protein may be a useful adjunctive procedure in the diagnosis of community-acquired pneumonia.
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