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9 mo baby was admitted with high fever, CRP 36, Amyloid a 238, procalcitonin 1.55, Physician’s order was Sulbin and fever is controlled, is it correct to give colchicine?
Hossam Elgnainy Selected answer as best
No — not yet.
The elevated procalcitonin (1.55) and response to antibiotics strongly suggest bacterial infection, not FMF.
FMF typically does not cause high procalcitonin, and fever does not usually resolve with antibiotics.
A single febrile episode in a 9-month-old, even with high amyloid, is not enough to diagnose FMF.
Hossam Elgnainy Selected answer as best
What Should Be Done:
1. Wait and observe:
Monitor for recurrent febrile episodes.
Check for patterns (frequency, duration, associated symptoms).
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2. Follow-up labs between episodes:
Repeat SAA, CRP, ESR in 2–4 weeks.
If still elevated when baby is well → chronic inflammation (supports FMF or other autoinflammatory disease).
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3. Genetic testing for MEFV gene:
If recurrent episodes occur or inflammation persists
Particularly important if there’s a family history or the child is of Mediterranean descent
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4. Start colchicine only if:
Clinical pattern fits FMF
OR MEFV mutation is confirmed
OR persistent unexplained inflammation, especially if SAA remains elevated