Monitoring Procalcitonin in Febrile Neutropenia
Author Information
Author(s): Robinson James Owen, Lamoth Frédéric, Bally Frank, Knaup Marlies, Calandra Thierry, Marchetti Oscar
Primary Institution: Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
Hypothesis
What is the utility of monitoring blood procalcitonin in febrile neutropenia for initial diagnosis of infection and reassessment in persistent fever?
Conclusion
Procalcitonin is not useful for diagnosing infection at the onset of neutropenic fever but may help distinguish severe infections among fevers of unknown origin on day 2 and contributes to early diagnosis of invasive mycoses in persistent fever.
Supporting Evidence
- Procalcitonin levels were significantly higher in non-CNS microbiologically documented infections compared to fevers of unknown origin.
- A PCT peak >500 pg/mL identified invasive fungal diseases with 81% sensitivity.
- Monitoring PCT can help avoid unnecessary investigations in patients with persistent fever.
Takeaway
Doctors can use a blood test called procalcitonin to help figure out if a sick person with a fever has a serious infection, especially if the fever lasts a long time.
Methodology
Procalcitonin levels were monitored in 194 febrile neutropenic episodes, with blood samples collected at various time points to assess infection diagnosis.
Potential Biases
Potential bias due to the lack of real-time PCT results for clinical decisions.
Limitations
The study is limited by its single-center design and the small number of proven invasive fungal diseases.
Participant Demographics
90 hematological patients, median age 57 (range 18–76), 61% male.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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