Wiener klinische Wochenschrift

, Volume 118, Issue 5–6, pp 170–174

Usefulness of procalcitonin to differentiate typical from atypical community-acquired pneumonia

Original Article

Summary

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.

Keywords

Procalcitonin Community-acquired pneumonia Etiology 

Stellenwert von Procalcitonin in der Differenzierung von typischer und atypischer ambulant erworbener Pneumonie

Zusammenfassung

HINTERGRUND: Es wurde die Wertigkeit erhöhter Procalcitonin-Serumkonzentrationen in der Differenzierung der typischen von der atypischen ambulant erworbenen Pneumonie erhoben und diese mit anderen in der klinischen Praxis üblicherweise verwendeten Parametern verglichen. PATIENTEN UND METHODEN: 30 konsekutive erwachsene Patienten, die wegen einer ambulant erworbenen Pneumonie an die Abteilung für Infektionskrankheiten des Medizinischen Universitätszentrums Ljubljana aufgenommen wurden, wurden in diese prospektive Studie eingeschlossen. Nur Patienten mit gesicherter bakterieller Pneumonie nahmen an der Studie teil. ERGEBNISSE: Der Median der Serum Procalcitonin-Konzentrationen lag bei der typischen Pneumonie bei 7,64 ng/ml (Range: 0,26–63,16) und bei der atypischen Pneumonie bei 0,80 ng/ml (Range: 0,13–34,90). Nur der bei der Aufnahme erhobene Procalcitoninwert der Patienten beider Gruppen unterschied sich signifikant. Die Standard-Laborparmeter wie CRP, Leukozytenzahl, und unreife polymorphonukleäre Zellen diskrimierten nicht zwischen typischer und atypischer Pneumonie. Der Median der Procalcitoninwerte war signifikant höher bei Patienten mit Bakteriämie. SCHLUSSFOLGERUNG: Die Bestimmung der Procalcitonin-Serumkonzentrationen kann nützliche zusätzliche Information bezüglich der Ätiologie einer Pneumonie geben und könnte daher einen wesentlichen Einfluss auf die intiale antimikrobielle Therapie haben.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Infectious DiseasesUniversity Medical CenterLjubljanaSlovenia

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