Role of neutrophil to lymphocyte and monocyte to lymphocyte ratios in the diagnosis of bacterial infection in patients with fever.
PURPOSE
To study the role of the neutrophil:lymphocyte ratio (NLR) and monocyte:lymphocyte ratio (MLR) in discriminating between different patient groups hospitalized for fever due to infection and those without infection.


METHODS
For 299 patients admitted to hospital for fever with unknown cause, a number of characteristics including NLR and MLR were recorded. These characteristics were used in a multiple multinomial regression analysis to estimate the probability of a final diagnostic group of bacterial, viral, clinically confirmed, or no infection.


RESULTS
Both NLR and MLR significantly predicted final diagnostic group. Being highly correlated, however, both variables could not be retained in the same model. Both variables also interacted significantly with duration of fever. Generally, higher values of NLR and MLR indicated larger probabilities for bacterial infection and low probabilities for viral infection. Patients with septicemia had significantly higher NLR compared to patients with other bacterial infections with fever for less than one week. White blood cell counts, neutrophil counts, and C-reactive proteins did not differ significantly between septicemia and the other bacterial infection groups.


CONCLUSIONS
NLR is a more useful diagnostic tool to identify patients with septicemia than other more commonly used diagnostic blood tests. NLR and MLR may be useful in the diagnosis of bacterial infection among patients hospitalized for fever.
['Naess|Are|A|http://orcid.org/0000-0002-5769-1995', 'Nilssen|Siri Saervold|SS|', 'Mo|Reidun|R|', 'Eide|Geir Egil|GE|', 'Sjursen|Haakon|H|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001424:Bacterial Infections D005260:Female D005334:Fever D006760:Hospitalization D006785:Hospitals, University D006801:Humans D007958:Leukocyte Count D008214:Lymphocytes D008297:Male D008875:Middle Aged D009000:Monocytes D015999:Multivariate Analysis D009504:Neutrophils D009664:Norway D014777:Virus Diseases D055815:Young Adult
Infections Fever Neutrophil:lymphocyte ratio (NLR) Monocyte:lymphocyte ratio (MLR)