Evaluation of febrile children often includes laboratory tests for inflammatory markers, such as white blood cell count (WBC) and C-reactive protein (CRP). The sensitivity of WBC in detecting bacterial infection is limited, according to various studies.1,2 In recent years, the CRP has come into use, with a higher level of accuracy.1,3 CRP >15 mg/dL was considered, in previous reports, as a “rule-in” level for bacterial diseases.4,6 

In the clinical situation, it is not uncommon to have normal WBC in cases of bacterial infection. In addition, physicians may encounter clinical conditions in which the WBC is normal while the CRP level is highly elevated, and this poses a diagnostic and therapeutic challenge.

Our aims were to estimate the prevalence of this combination among pediatric patients presenting at our emergency department (ED) with fever and characterize their epidemiologic and clinical features, as...

You do not currently have access to this content.