PEDIATRICS Vol. 62 No. 4 October 1978, pp. 619
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Letter To The Editor

Paul L. McCarthy M.D.1, Thomas F. Dolan M.D.1, and James F. Jekel M.D.2

1 Departments of Pediatrics, 789 Howard Avenue New Haven, CT 06504
2 Departments of Pediatrics and Epidemiology and Public Health, Yale New Haven Hospital, 789 Howard Avenue New Haven, CT 06504

Dr. Todd has written a thoughtful commentary on our recent article.

All tests, alone or in combination, including the medical history and physical examination, have false-positive and false-negative errors. The balance between these errors is, as Dr. Todd mentions, determined by the cutoff points we choose. Although other cutoff points for WBC count and ESR were studied, a WBC count of 15,000/cu mm or more and an ESR of 30 mm/hr or more demonstrated the best balance of specificity and sensitivity for bacteremia or pneumonia in young children who had a temperature of 4°C or more.