Potential use of procalcitonin as a diagnostic criterion in febrile neutropenia: Experience from a multicentre study

  • Giamarellou H
  • Giamarellos-Bourboulis E
  • Repoussis P
 et al. 
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In order to assess the diagnostic value of procalcitonin, 158 patients with febrile neutropenia from centres across Europe were studied. Patients with fever were diagnosed on the basis of either: (1) clinical, radiological and microbiological criteria; or (2) the procalcitonin value. In the latter case, concentrations of 0.5-1.0 ng/mL were considered diagnostic of localised infection, concentrations of 1.0-5.0 ng/mL of bacteraemia, and concentrations of > 5.0 ng/mL of severe sepsis. Procalcitonin and C-reactive protein were estimated daily in serum by immunochemiluminescence and nephelometry, respectively. Overall, the sensitivity (specificity) of procalcitonin for bacteraemia was 44.2% (64.3%) at concentrations of 1.0-5.0 ng/mL, and 83.3% (100%) for severe sepsis at concentrations of > 5.0 ng/mL. It was concluded that procalcitonin is a marker strongly suggestive of severe sepsis at concentrations of > 5.0 ng/mL. Estimated concentrations of < 0.5 ng/mL indicate that infection is unlikely, but it was observed that bacteraemia associated with coagulase-negative staphylococci may fail to elevate serum procalcitonin levels.

Author-supplied keywords

  • Bacteramia
  • C-reactive protein
  • Diagnosis
  • Fever
  • Procalcitonin

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  • H. Giamarellou

  • E. J. Giamarellos-Bourboulis

  • P. Repoussis

  • L. Galani

  • N. Anagnostopoulos

  • P. Grecka

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