Could procalcitonin be a predictive biological marker in systemic fungal infections?

Christofilopoulou, Sofia; Charvalos, Ekatherina; Petrikkos, George

doi:10.1016/s0953-6205(02)00160-7

Cited by 37 publications

(32 citation statements)

References 5 publications

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“…Secondly, both HIV and TB are associated with elevated circulating levels of inflammatory cytokines, particularly tumour necrosis factor-a [16,17]. This cytokine has been shown to induce the production of PCT independent of the presence of bacterial endotoxins [18], and may account for the elevated PCT levels found in conditions other than bacterial sepsis, such as malaria [19] and systemic fungal infections [20]. Finally, mixed pulmonary infections with multiple pathogens are not uncommon in HIV-seropositive patients [21,22] and the elevated PCT levels observed may have been related to undiagnosed and concomitant bacterial infection.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin and C-reactive protein levels in HIV-positive subjects with tuberculosis and pneumonia

Schleicher

Herbert²,

Brink³

et al. 2005

European Respiratory Journal

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Pulmonary tuberculosis (PTB) and pneumococcal community-acquired pneumonia (PCAP) are common causes of lower respiratory tract infections in HIV-seropositive patients and may have similar clinical and radiological features. This study aimed to assess the value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in HIV-seropositive patients with pneumonia, and to investigate their potential role in differentiating pneumococcal from mycobacterial infections.HIV-seropositive patients admitted with pneumonia were evaluated prospectively, 34 with PTB and 33 with PCAP.All 33 patients in the PCAP group and 20 of 34 patients in the PTB group had elevated PCT levels (.0.1 ng?mL -1 ). All patients in both groups had elevated CRP levels (.10 mg?L -1). The PTB group had significantly lower CD4 T-lymphocyte counts, lower CRP levels, lower white cell counts, and lower PCT levels than the PCAP group. Receiver operating characteristic analysis showed that optimal discrimination between PTB and PCAP could be performed at a cut-off point of 3 ng?mL -1 for PCT (sensitivity 81.8%; specificity 82.35%) and 246 mg?L -1 for CRP (sensitivity 78.8%; specificity 82.3%).In conclusion, HIV-seropositive patients with pneumococcal community-acquired pneumonia had significantly higher procalcitonin and C-reactive protein levels than those with pulmonary tuberculosis. A procalcitonin level .3 ng?mL -1 and a C-reactive protein level .246 mg?L -1 were both highly predictive of pneumococcal infection.

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Section: Discussionmentioning

confidence: 99%

Procalcitonin and C-reactive protein levels in HIV-positive subjects with tuberculosis and pneumonia

Schleicher

Herbert²,

Brink³

et al. 2005

European Respiratory Journal

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“…Christofilopoulou et al attributed no diagnostic value, but did attribute a prognostic value, to PCT in severe fungal infections [4]. However, the clinical relevance of this observation seems questionable in light of missing therapeutic consequences.…”

Section: Discussionmentioning

confidence: 99%

“…Seven articles [4,6,[8][9][10][11]18] provided data on PCT levels in 34 cases of culture-proven candidiasis (candidemia n=16, hepatosplenic candidiasis n=3, necrotic otitis n=1, culture from various normally sterile sites n=14). A wide range of PCT peak levels (0.38-238 ng/ml) were reported.…”

Section: Review Of the Literaturementioning

confidence: 99%

Procalcitonin—a marker of invasive fungal infection?

Dornbusch

Strenger

Kerbl

et al. 2005

Support Care Cancer

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Procalcitonin (PCT) has been described as a marker of bacterial sepsis. However, little is known of its diagnostic value in fungal infections. We calculated the sensitivity of PCT for detection of invasive fungal infections (IFI) by analyzing 55 episodes of proven or probable IFI (three in our series, 52 reported in the recent literature). In the early phase of IFI, PCT was elevated in fewer than half of invasive candidiasis episodes and in only one patient (5.3%) with invasive aspergillosis. Due to low sensitivity and specificity, PCT adds little to the diagnosis of IFI.

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“…5 In contrast to cytokines such as tumor necrosis factor (TNF) and interleukin-6 (IL-6), PCT rises specifically in bacterial processes 1 and not in response to other types of inflammation (e.g., viral infection, organ transplant rejection, or autoimmune diseases). 6 Its behavior in systemic fungal infections is controversial; whereas some reports found a correlation with the severity infection, 7 other reports found poor PCT sensitivity in this setting. 8 Currently, the origin of the considerable secretion of PCT in sepsis is unclear, but monocytes and an acute-phase origin from the neuroendocrine cells in the liver, lungs, or intestine are candidates.…”

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confidence: 99%

Assessment of procalcitonin as a diagnostic and prognostic marker in patients with solid tumors and febrile neutropenia

Jimeno

García-Velasco

Val

et al. 2004

Cancer

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Could procalcitonin be a predictive biological marker in systemic fungal infections?

Cited by 37 publications

References 5 publications

Procalcitonin and C-reactive protein levels in HIV-positive subjects with tuberculosis and pneumonia

Procalcitonin and C-reactive protein levels in HIV-positive subjects with tuberculosis and pneumonia

Procalcitonin—a marker of invasive fungal infection?

Assessment of procalcitonin as a diagnostic and prognostic marker in patients with solid tumors and febrile neutropenia

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