Role of the Acute Phase Reactans for Differential Diagnosis at Acute Gastroenteritis in Children

Background/Aims:Acute gastroenteritis in children is still a major public health problem for our country. Antibacterial and antiparasitic treatment of AGEs should be given in selected cases. For the planning of antibacterial and antiparasitic treatment, physical examination and medical history, especially the tests to be conducted for etiology, are needed. Routine laboratory tests for AGEs etiology are difficult to reach for patients who live far from fully equipped hospitals. It is attempted to diagnose bacterial, parasitic or viral AGE with the evaluation of acute phase reactants, physical examination and the history of patients. Sometimes empirical antibacterial and antiparasitic treatments can be seen as a solution for these patients. In this study, we aimed to investigate how acute phase reactants that can be measured routinely play a role in the differential diagnosis of bacterial, parasitic and viral AGEs.Methods:In this study, the data of 126 cases, comprising 39 bacterial, 38 parasitic and 49 viral acute gastroenteritis diagnosed cases, were evaluated retrospectively. Cases were divided into 3 groups according to their diagnosis.Results:No significant difference by gender was found between groups. The mean age of viral gastroenteritis cases was smaller compared to the other two groups. Mean Platelet Volume values of the bacterial gastroenteritis group were higher than the other two groups. Alanine aminotransferase and AST levels of viral gastroenteritis cases were higher than the other two groups. Most infection markers (WBC, ANS, ALS and AMS) showed no significant differences among the three groups. However, AES value was higher in the group of parasitic gastroenteritis cases. Also, ESR and CRP levels were higher in the group of bacterial gastroenteritis.Conclusions:ESR and CRP levels, as acute phase reactants, can rule out viral acute gastroenteritis from bacterial and parasitic acute gastroenteritis in the differential diagnosis of acute gastroenteritis agents, but they are insufficient to distinguish between bacterial and parasitic acute gastroenteritis agents. In this study, a higher presence of eosinophils in parasitic acute gastroenteritis cases was a result that we expected.