A term neonate evaluated at 4 hours of life for maternal intrapartum fever has C-reactive protein of 2 mg/L (normal). The attending physician is considering stopping the sepsis workup based on this value alone. What is the correct interpretation of this result?
- A A normal CRP excludes bacterial sepsis and antibiotics can safely be stopped
- B CRP is elevated from birth in all neonates, making it unusable in the first week of life
- C CRP rises only 6 to 12 hours after the infectious insult, so a single early normal value does not exclude sepsis ✓
- D CRP peaks within 2 hours of bacterial invasion and falls by 12 hours
Correct answer: C. CRP rises only 6 to 12 hours after the infectious insult, so a single early normal value does not exclude sepsis
Explanation
CRP is an acute phase reactant synthesized by the liver that begins rising 6 to 12 hours after the inflammatory stimulus and peaks around 24 to 48 hours. A single value obtained very early in life can therefore be falsely reassuring. Serial CRP measurements, typically two values 12 to 24 hours apart, have far better negative predictive value than one sample. Option A is the dangerous error this fact prevents.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.