[Skip to Navigation]
February 3, 2020

C-Reactive Protein Testing in Late-Onset Neonatal Sepsis: Hazardous Waste

Author Affiliations
  • 1Department of Pediatrics, University of Texas Health, San Antonio
  • 2Division of Pediatric Infectious Diseases, University of Texas Health, San Antonio
  • 3Division of Neonatology, University of Texas Health, San Antonio
JAMA Pediatr. 2020;174(3):235-236. doi:10.1001/jamapediatrics.2019.5684

Imagine for a moment you are counseling a patient with a suspicious mass and symptoms that are concerning but nonspecific. Although there are several possible diagnoses, one hangs unspoken between you and the patient—a diagnosis that carries significant morbidity and mortality. You propose an immediate biopsy. After all, a tissue diagnosis is the criterion standard, and this matter is urgent. The patient agrees, and as the patient begins to stand, you raise a hand and mention another test you would like to order. The patient is curious. “What are the benefits of this test?” You explain that the test involves sending a portion of the biopsied tissue to a separate part of the laboratory, where the pathology department will look for other markers of disease. Of course, the patient nods; that makes sense. “If this extra test result is negative, I will be okay, right?” “No,” you answer, “a negative test result does not mean the biopsy result will be negative.” The patient frowns. “Well, is it a bad sign if the test result is positive?” “Not necessarily,” you explain. “Many things can make the other test results abnormal, so we’ll still have to wait on the biopsy results. The biopsy is the key.” The patient sits down again, looking confused. “If the biopsy is so important, why are we wasting tissue on this other test?” “Well,” you glance helplessly toward the window then look back to your frowning patient. “It’s just what we’ve always done in these cases.”

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words