Diagnostic value of pleural fluid and serum procalcitonin levels in the diagnosis of parapneumonic pleural effusion

Doğan, Canan Sercan; Bilaçeroğlu, Semra; Çırak, Ali Kadri; Özsöz, Ayşe; Özbek, Defne

doi:10.5578/tt.5334

Cited by 5 publications

(6 citation statements)

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“…In the same study, higher leukocyte counts, fever and CRP values (p<0.05) were detected in the PPE group. [6] In our study, in the PPE group significantly higher leukocyte counts were detected (p<0.001). Although a higher percentage of neutrophils was observed in the PPE group, any statistically significant intergroup difference could not be noted.…”

Section: Discussionsupporting

confidence: 50%

“…In similar studies investigating the PPE PCT level, the presence of additional disease was also addressed. In the study conducted by Doğan et al, [6] any significant difference was not reported between the PPE and non-PPE groups concerning the presence of additional diseases. In another study, the presence of comorbid disease was significantly more frequent in the MPE group compared to the PPE group (p<0.001).…”

Section: Discussionmentioning

confidence: 80%

“…In a similar study by Doğan et al, [6] 65 patients with exudative pleural fluid were included in this study. In this study, PCT levels in pleural fluid and serum were compared in the patients diagnosed as PPE, and higher pleural fluid PCT levels (average values of PCT: 0.03 ng/mL vs 1.03 ng/mL) and serum PCT levels (average values of PCT: 0.05 ng/mL vs 0.90 ng/mL) were detected in the PPE group (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

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The role of pleural fluid procalcitonin in the differential diagnosis in parapneumonic pleural effusions and its relation with the ultrasound image of the pleural fluid

Akkurt¹

2019

South Clin Ist Euras

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is a highly specific marker for the detection of infectious diseases. In recent years, studies on this marker have been conducted in patients with pleural fluid. Our aim in this study is to investigate the role of pleural fluid procalcitonin level in distinguishing parapneumonic pleural effusion (PPE) from other causes of exudative pleural effusion and its relationship with thorax ultrasonography (USG). Methods: A total of 128 exudative pleural effusion patients were included in this study. The patients were divided into two groups as PPE and non-PPE. Demographic findings, comorbidities, radiographic images in chest radiography and thorax USG, hemogram and CRP results, albumin, protein, lactate dehydrogenase (LDH) and glucose levels in pleural fluid and pleural fluid cell count were recorded. Pleural fluid PCT levels, serum PCT levels and thoracic USG images of PPE and non-PPE groups were compared statistically with each other. P-value <0.05 was considered statistically significant. Results: Of the 128 patients, 71 (55%) were diagnosed with PPE and 57 (45%) were diagnosed with non-PPE causes. There was no significant difference in the level of pleural fluid PCT and serum PCT levels between the PPE and non-PPE groups (p=0.31 and p=0.21, respectively). No statistically significant difference was found between the anechoic fluids and the complex pleural effusion without septum in the PPE and non-PPE groups (p=0.079 and p=0.147, respectively). However, complex septated fluids were higher in PPE group and this difference was statistically significant (p=0.003). Conclusion: It was found that the pleural fluid PCT and serum PCT measurements in the PPE did not have a diagnostic value. Pleural fluid PCT/serum PCT ratio were not significantly different between the two groups. In addition, there was no correlation between thoracic USG images and PCT levels.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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The role of pleural fluid procalcitonin in the differential diagnosis in parapneumonic pleural effusions and its relation with the ultrasound image of the pleural fluid

Akkurt¹

2019

South Clin Ist Euras

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“…In a prospective study, Doğan et al compared 33 patients with parapneumonic effusions (including 22 empyemas) with controls (nonparapneumonic effusions). Using a cut-off level of 0.105 ng/mL, the sensitivity and specificity of PCT were 67% and 97%, respectively [9]. This case and the evidence from these studies demonstrate that PCT may remain low in localized or contained pulmonary infection, even when clinically and radiologically advanced.…”

Section: Discussion and Literature Reviewmentioning

confidence: 98%

Necrotizing Pseudomonas aeruginosa Community-Acquired Pneumonia: A Case Report and Review of the Literature

Maharaj

Isache

Seegobin

et al. 2017

Case Reports in Infectious Diseases

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Lung cavities are not typically associated with community-acquired pneumonia (CAP). CAP due to P. aeruginosa is rare and even less commonly causes necrotizing pneumonia. We report a case of P. aeruginosa CAP that progressed to necrotizing pneumonia and was eventually fatal. Procalcitonin (PCT) has been well investigated in guiding antibiotic therapy (especially CAP) in adults. In this case, PCT at presentation and sequentially was negative. We discuss this caveat and present hypotheses as to the sensitivity and specificity of PCT and C-reactive protein (CRP) in these patients. To better characterize P. aeruginosa CAP, we undertook a review of cases indexed in PubMed from 2001 to 2016 (n = 9). The data reveal that risk factors for P. aeruginosa CAP include smoking, alcohol use, obstructive lung disease, sinusitis, and hot tub use. The route of infection for P. aeruginosa CAP remains unknown. One of the most interesting findings on reviewing cases was that P. aeruginosa CAP involves the right upper lobe in the vast majority. We suggest that when physicians in the community see patients with distinctly upper lobe necrotizing or cavitary pneumonia, they should consider P. aeruginosa in their differential diagnosis. Further studies are needed to clarify route of infection, role of PCT and CRP, and optimal therapy including drug and duration.

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“…18 Estudios más recientes han explorado valores de PCT para identificar causas infecciosas del derrame pleural (DP). 19 Entre las limitantes de los estudios se encuentra la falta de análisis en suero, reproducibilidad de los hallazgos y la variación del rendimiento diagnóstico entre poblaciones. Por tal motivo, el objetivo principal del presente estudio es analizar el comportamiento de PCT sérica al ser evaluada de forma sistematizada en un grupo de pacientes mexicanos confirmados con DPN.…”

Section: Introductionunclassified

Procalcitonina sérica como biomarcador diagnóstico de derrame paraneumónico o empiema

Vega-Sánchez

Che-Morales

Vargas-Mendoza

et al. 2017

NCT Neumología Y Cirugía De Tórax

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Este artículo puede ser consultado en versión completa en http://www.medigraphic.com/neumologia RESUMEN. Antecedentes: La relevancia del derrame paraneumónico (DPN) y empiema, radica en su morbimortalidad y tendencia ascendente. Recién ha tomado interés la exploración de nuevos biomarcadores capaces de incidir en su desenlace. La procalcitonina (PCT) es un sólido marcador de infección sistémica; sin embargo, son escasos los trabajos que describen su comportamiento en DPN y empiema. Este estudio exploró si la PCT tiene un papel en el abordaje diagnóstico del derrame pleural unilateral de causa infecciosa manifestado como DPN y/o empiema. Material y métodos: Diseñamos un estudio clínico observacional prospectivo que incluyó a pacientes ingresados a nuestra institución con derrame pleural unilateral por un período de 18 meses. Se analizó el contraste del valor absoluto de PCT sérica en dos grupos de estudio y la probabilidad de predecir infección defi nida como DPN y/o empiema. Resultados: Se incluyeron 49 pacientes divididos en dos grupos (infeccioso vs. no infeccioso). Al ingreso, el valor de PCT sérica fue diferente entre ambos grupos (1.42 ng/mL vs. 0.83 ng/mL). El análisis de regresión identifi có que PCT sérica tuvo adecuada asociación con infección pleural. El valor de PCT que mejor discriminó este hallazgo fue ≥ 2 ng/mL, OR 4.1 (IC 95% 1.1-15.3; p = 0.038). Conclusiones: Procalcitonina es un biomarcador sérico útil en el diagnóstico de infección pleural. Sin embargo, deben realizarse más estudios para comprobar nuestros resultados.

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Diagnostic value of pleural fluid and serum procalcitonin levels in the diagnosis of parapneumonic pleural effusion

Abstract: PS/S-PCT levels were found to be highly efficient in excluding PPPE but not sufficiently reliable in the diagnosis of it. However, these findings should be reassessed in a larger group of cases that have not been given any antibiotic/anti-inflammatory treatment.

Cited by 5 publications

References 0 publications

The role of pleural fluid procalcitonin in the differential diagnosis in parapneumonic pleural effusions and its relation with the ultrasound image of the pleural fluid

The role of pleural fluid procalcitonin in the differential diagnosis in parapneumonic pleural effusions and its relation with the ultrasound image of the pleural fluid

Necrotizing Pseudomonas aeruginosa Community-Acquired Pneumonia: A Case Report and Review of the Literature

Procalcitonina sérica como biomarcador diagnóstico de derrame paraneumónico o empiema

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