Usefulness of Procalcitonin to Differentiate Typical from Atypical Community-acquired Pneumonia

Overview

Journal Wien Klin Wochenschr

Publisher Springer

Specialty General Medicine

Date 2006 Jun 15

PMID 16773483

Citations 12

Authors

Matjaz Jereb

Tadeja Kotar

Affiliations

Soon will be listed here.

Abstract

Background: The value of elevated serum procalcitonin concentration for differentiating between typical and atypical community-acquired pneumonia was assessed and compared with other parameters that are usually used in clinical practice.

Patients And Methods: Thirty consecutive adult patients with community-acquired bacterial pneumonia admitted to the Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia, were included in this prospective study. Only those patients for whom the etiology of bacterial pneumonia was confirmed participated in the study.

Results: The median serum procalcitonin level in patients with typical pneumonia was 7.64 ng/ml (range 0.26-63.16) and in the group with atypical pneumonia 0.80 ng/ml (range 0.13-34.90). A significant difference between the typical and atypical pneumonia groups was found only for the procalcitonin serum concentration on admission. The standard laboratory markers of bacterial infections, such as C-reactive protein, total leukocyte count and immature polymorphonuclear cells, did not discriminate between typical and atypical etiology. Median procalcitonin levels were significantly higher among patients with bacteremic pneumonia.

Conclusions: Determination of the procalcitonin level may provide useful additional diagnostic information on the etiology of pneumonia and could have a crucial influence on the initial antimicrobial therapy.

Citing Articles

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References

Povoa P, Almeida E, Moreira P, Fernandes A, Mealha R, Aragao A . C-reactive protein as an indicator of sepsis. Intensive Care Med. 1998; 24(10):1052-6. DOI: 10.1007/s001340050715. View

Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay M, Huber P, Tamm M . Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet. 2004; 363(9409):600-7. DOI: 10.1016/S0140-6736(04)15591-8. View

Remskar M, Horvat M, Hojker S, Noc M . Procalcitonin in patients with acute myocardial infarction. Wien Klin Wochenschr. 2002; 114(5-6):205-10. View

Toikka P, Irjala K, Juven T, Virkki R, Mertsola J, Leinonen M . Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bacterial and viral pneumonia in children. Pediatr Infect Dis J. 2000; 19(7):598-602. DOI: 10.1097/00006454-200007000-00003. View

Dandona P, Nix D, Wilson M, Aljada A, Love J, Assicot M . Procalcitonin increase after endotoxin injection in normal subjects. J Clin Endocrinol Metab. 1994; 79(6):1605-8. DOI: 10.1210/jcem.79.6.7989463. View

Gleason P, Meehan T, Fine J, Galusha D, Fine M . Associations between initial antimicrobial therapy and medical outcomes for hospitalized elderly patients with pneumonia. Arch Intern Med. 1999; 159(21):2562-72. DOI: 10.1001/archinte.159.21.2562. View

Polzin A, Pletz M, Erbes R, Raffenberg M, Mauch H, Wagner S . Procalcitonin as a diagnostic tool in lower respiratory tract infections and tuberculosis. Eur Respir J. 2003; 21(6):939-43. DOI: 10.1183/09031936.03.00055103. View

Gendrel D, Raymond J, Assicot M, Moulin F, Iniguez J, Lebon P . Measurement of procalcitonin levels in children with bacterial or viral meningitis. Clin Infect Dis. 1997; 24(6):1240-2. DOI: 10.1086/513633. View

Fleischhack G, Cipic D, Juettner J, Hasan C, Bode U . Procalcitonin-a sensitive inflammation marker of febrile episodes in neutropenic children with cancer. Intensive Care Med. 2008; 26 Suppl 2:S202-11. DOI: 10.1007/BF02900739. View

10.

Yentis S, Soni N, Sheldon J . C-reactive protein as an indicator of resolution of sepsis in the intensive care unit. Intensive Care Med. 1995; 21(7):602-5. DOI: 10.1007/BF01700168. View

11.

Muller B, White J, Nylen E, Snider R, Becker K, Habener J . Ubiquitous expression of the calcitonin-i gene in multiple tissues in response to sepsis. J Clin Endocrinol Metab. 2001; 86(1):396-404. DOI: 10.1210/jcem.86.1.7089. View

12.

Moulin F, Raymond J, Lorrot M, Marc E, Coste J, Iniguez J . Procalcitonin in children admitted to hospital with community acquired pneumonia. Arch Dis Child. 2001; 84(4):332-6. PMC: 1718706. DOI: 10.1136/adc.84.4.332. View

13.

Al-Nawas B, Krammer I, Shah P . Procalcitonin in diagnosis of severe infections. Eur J Med Res. 1996; 1(7):331-3. View

14.

Brunkhorst F, Wegscheider K, Forycki Z, Brunkhorst R . Procalcitonin for early diagnosis and differentiation of SIRS, sepsis, severe sepsis, and septic shock. Intensive Care Med. 2008; 26 Suppl 2:S148-52. DOI: 10.1007/BF02900728. View

15.

Hausfater P, Garric S, Ben Ayed S, Rosenheim M, Bernard M, Riou B . Usefulness of procalcitonin as a marker of systemic infection in emergency department patients: a prospective study. Clin Infect Dis. 2002; 34(7):895-901. DOI: 10.1086/339198. View

16.

Simon L, Gauvin F, Amre D, Saint-Louis P, Lacroix J . Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis. 2004; 39(2):206-17. DOI: 10.1086/421997. View

17.

Houck P, MacLehose R, Niederman M, Lowery J . Empiric antibiotic therapy and mortality among medicare pneumonia inpatients in 10 western states : 1993, 1995, and 1997. Chest. 2001; 119(5):1420-6. DOI: 10.1378/chest.119.5.1420. View

18.

Marrie T . Community-acquired pneumonia. Clin Infect Dis. 1994; 18(4):501-13; quiz 514-5. DOI: 10.1093/clinids/18.4.501. View

19.

Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C . High serum procalcitonin concentrations in patients with sepsis and infection. Lancet. 1993; 341(8844):515-8. PMC: 7141580. DOI: 10.1016/0140-6736(93)90277-n. View

20.

Linscheid P, Seboek D, Nylen E, Langer I, Schlatter M, Becker K . In vitro and in vivo calcitonin I gene expression in parenchymal cells: a novel product of human adipose tissue. Endocrinology. 2003; 144(12):5578-84. DOI: 10.1210/en.2003-0854. View