Print

Print


Ignore it!  Go with your gut and clinical impression.

I think I would have been more of a test minimalist in this situation.  Did the history really lead you to need a CXR, urine, or labs?  Does an ESR or CRP in this situation at all help you one way or another?  (is there a study that shows that a negative CRP or ESR rules out all disease)  

I know fighting anxious parents is sometimes a losing battle, but this mom has now been empowered to ask for at least the same if not more next time.  (Deep down inside I would have wanted to ask the lab to poke the mom for a couple of sets of blood cultures to rule out endocarditis, and then asked her if she wanted her little one poked also)

Terence

On 2011-01-12, at 9:04 PM, don zweig wrote:

> How do you use the crp in evaluating kids?  How do you interpret a high crp with low sed rate.  I had a 8 yo with headache, decreased appetite and dizziness. No nvd.  Neg pmh.  Vitals normal with t=37.4 oral.  min cough.  no dysuria.  Labs show normal wbc and diff, noraml chem7, lft, cxr.  Very healthy appearing with large tonsils that are not inflamed. no nodes. supple neck.  crp ws 38. i was hoping for normal.  urine showed 80 red cells, 4 wbc, no back and 39 epith cells.  no abd or flank pain.
> 
> Should i go with my impressing that she is well.  I did labs because mother was concerned, child seemed to be usually healthy and not a complainer..  Was shooting for reassurance.  did not image brain or tap.
> 
> help
> 
> don
> 
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                 http://listserv.brown.edu/ped-em-l.html
> 

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html