Can procalcitonin measurement help in differentiating between bacterial infection and other kinds of inflammatory processes?

Abstract

Objective: To study the levels of procalcitonin (PCT) in various inflammatory states seen in an internal medicine department and to evaluate the possible discriminative role of PCT in differentiating bacterial infection from other inflammatory processes. Methods: PCT, C reactive protein (CRP), and white blood cell count (WBC) were measured in patients admitted to the department for fever or biological inflammatory syndrome, or both. The serum of 173 consecutive patients was analysed according to the aetiological diagnosis. The patients were divided into two groups: group I (n=60) with documented bacterial or fungal infection; group II (n=113) with abacterial inflammatory disease. Results: PCT levels were >0.5 ng/ml in 39/60 (65%) patients in group I. In group II, three patients with a viral infection had slightly increased PCT levels (0.7, 0.8, and 1.1 ng/ml) as did two others, one with crystal arthritis and the other with vasculitis (0.7 ng/ml in both cases). All other patients in group II had PCT levels <0.5 ng/ml. In this study a value of PCT >0.5 ng/ml was taken as the marker of bacterial infection (sensitivity 65%, specificity 96%). PCT values were more discriminative than WBC and CRP in distinguishing a bacterial infection from another inflammatory process. Conclusion: PCT levels only rose significantly during bacterial infections. In this study PCT levels >1.2 ng/ml were always evidence of bacterial infection and the cue for starting antibiotic treatment.

High Procalcitonin in a Patient with Drug Hypersensitivity Syndrome

“…(8,9). Mild to moderate increases of the PCT level may occur in viral infections and various chronic inflammatory diseases (arthritis, vasculitis) (8,10 (12), and the test was positive.…”

Evaluation of serum procalcitonin as a significant marker in cases of septic arthritis and osteomyelitis: a two year study

“…These findings of our study were on par with the findings of many studies conducted but in contrast with findings of Delevaux et al who reported that PCT was 100% sensitive and 100% specific with 100% PPV. 13 However there are only few studies in Indian scenario comparing the efficacy of PCT in diagnosing septic and OA in adults.…”

Procalcitonin Testing in Rheumatology

“…В работе I. Delevaux и соавт. [35], включавшей 13 пациентов с гигантоклеточным артериитом без инфекции, меди-ана ПКТ составляла 0,1 нг / мл, СРБ -84 мг / л. Для ди-агностики бактериальных инфекций у этих пациентов авторы предлагают использовать пограничное значе-ние ПКТ, равное 0,5 нг / мл. В 2014 г. итальянские уче-ные показали, что уровень ПК не повышался у паци-ентов с активным артериитом Такаясу, в то время как значения СОЭ и СРБ возрастали.…”