In clinical practice, distinguishing between viral and bacterial infections is crucial for developing effective treatment plans. Please explain in detail how to effectively distinguish these two types of infections through routine blood tests and C-reactive protein (CRP) levels. Specifically, viral infections are usually manifested by normal or slightly low white blood cell counts and an increased proportion of lymphocytes, while bacterial infections are often manifested by significantly increased white blood cell counts and an increased proportion of neutrophils. In addition, CRP levels are usually higher in bacterial infections, while CRP levels are often lower in viral infections. Based on these laboratory test results, please explain how to make effective judgments and applications in clinical practice.
The clinician has to take his or her time to carry out the needed investigations to conclude on what the cause of fever is. In the first place, fever is not only caused by infections. A good history as well as a good physical examination should be able to provide the clinician with what sample should be taken for further investigation. Samples such as stool, urine, sputum, blood etc may be taken for further investigation. When an intervention is needed urgently, control of the temperature would have to be done while a blood test, urine test, or stool test can distinguish between a bacterial or viral infection. However, this is dependent on other presenting symptoms or signs. Samples for lab investigations should however be taken before antibiotics are administered in the case one suspects bacterial infection. Most viral infections are self-limiting. However, some viral infections especially those affecting the respiratory system may predispose to bacterial invasion and that may exacerbate the condition and may have to be tackled with antibiotics. Eg includes treating COVID-19 with Azithromycin, Zinc tablets, and Vitamin C.
In summary detailed examination of the patient with suitable further investigations can help decide the mode of treatment either towards a bacterial infection or viral.
I hope this is helpful
Dear Aoife O'Sullivan
In viral infection, symptoms are short lasting. A lot of times the symptoms last for maybe three days to a week and then slowly get better over time. Sometimes the cough can be persistent up to a month.
On the other hand, if there’s a bacterial infection, may be the result of "secondary infection" (meaning that the virus initiated the process but a bacteria followed), then symptoms persist longer than the expected 10-14 days, a virus tends to last. Also, fever may be higher than one might typically expect from a virus and may get worse a few days into the illness rather than improving.
In the below attached paper, the study demonstrates the potential of machine learning models, particularly the Virus vs Bacteria model, based on the most frequently measured blood parameters and CRP, in differentiating between bacterial and viral infections.
It may be helpful!
https://www.cell.com/heliyon/pdf/S2405-8440(24)05403-3.pdf
Regards,
Malcolm Nobre
- Badges
- Science topic