University of Wisconsin–Madison Medical College of Wisconsin

Evaluating Uncommon Inflammatory Markers in Common Pediatric Bacterial Infections

Christina M. McKinney, MD; Michelle L. Mitchell, MD; Erin Preloger, MD; Kelly Graff, MD; Amy Y. Pan, PhD; Melodee Liegl, MA; Glenn Bushee, MS; Patrick J. McCarthy, MD, MME; Vanessa McFadden, MD, PhD; Sarah Corey Bauer, MD

WMJ. 2026;125(2):280-282. Published June 2, 2026.

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ABSTRACT

Background: Expected ranges for several inflammatory markers in children were poorly defined during the COVID-19 pandemic, making it difficult to distinguish common infections from multisystem inflammatory syndrome in children (MIS-C). We evaluated less commonly obtained inflammatory markers in children with common bacterial infections.

Methods: We completed a retrospective cohort study at a tertiary children’s hospital from March 2018 through April 2023 of hospitalized patients >60 days to 21 years with cellulitis, community-acquired pneumonia, or urinary tract infection.

Results: A total of 973 patients were included (median age, 5.6 years; interquartile range, 1.9-12.2; 61% female). Most inflammatory markers were elevated across infections, whereas troponin levels remained within the reference range for all diagnoses.

Discussion: We report values for less commonly obtained inflammatory markers in children hospitalized with common bacterial infections. Normal troponin levels may help distinguish these infections from MIS-C, which more commonly involves cardiac inflammation. Further research is needed to define clinically useful cutoff values for inflammatory markers to aid decision-making in the setting of emerging disease processes.


Author affiliations: Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio (McKinney); Division of Infectious Diseases, Department of Pediatrics, Medical College of Wisconsin (MCW), Milwaukee, Wisconsin (Graff, Mitchell); Section of Pediatric Hospital Medicine, Department of Pediatrics, MCW, Milwaukee, Wisconsin (Corey Bauer, McFadden, Preloger); Division of Bioinformatics and Quantitative Child Health, Department of Pediatrics, MCW, Milwaukee, Wisconsin (Pan, Liegl); Department of Quality and Safety, MCW, Milwaukee, Wisconsin (Bushee); Aurora Children’s Health, Advocate Aurora Health, Milwaukee, Wisconsin (McCarthy).
Corresponding author:
Christina M. McKinney, MD, 3333 Burnet Ave, MLC 9016, Cincinnati, OH, 45229; email christina.mckinney@cchmc.org; ORCID ID 0009-0002-9372-7980
Financial disclosures: Kelly Graff is a consultant for and receives research support from BioFire Diagnostics, LLC; this company did not participate in this work.
Funding/support:
Statistician time for this work was supported by the Medical College of Wisconsin Department of Pediatrics.
Acknowledgements:
The authors wish to acknowledge Kelsey Porada, MA, for assistance with institutional review board submission and data formatting.


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