Abstract
Objective
To evaluate the usefulness of procalcitonin (PCT) as a point-of-care testing to screen for radiographic pneumonia among children with influenza-like illness (ILI) and prolonged fever.
Methods
A prospective cohort study conducted at the pediatric emergency department of a tertiary hospital. Point-of-care testing for PCT was determined for 185 children aged 3 months to < 18 years with ILI and fever lasting > 4 days seen during the flu season in 2020. A chest radiograph (CXR) was performed for patients with PCT > 0.5 ng/mL.
Results
PCT value was > 0.5 ng/mL in 46 (24.9%) patients; a CXR was ordered in all cases except one and 14 (31.1%) of them had radiographic pneumonia (all had a PCT value > 0.7 ng/mL). Among the 139 (75.1%) patients with a PCT value ≤ 0.5 ng/mL, 137 (98.6%) were managed in the outpatient with symptomatic treatment; the remaining two cases warranted a CXR which was unremarkable in both. At evolution, no radiographic pneumonia was diagnosted in any of them.
Conclusion
PCT is a useful tool for point-of-care testing in patients with ILI and fever > 4 days to guide the indication for CXR to rule out radiographic pneumonia and helps in avoiding unnecessary radiation exposure.
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Funding
Funding: This study was partly supported by Brahms Diagnostica, GmbH, Berlin, Germany, who provided the Thermo Scientific™ B·R·A·H·M·S PCT™ direct test instrument and kits for the study. The study sponsor played no role in the study design, data collection, data analysis, or interpretation of results; writing of the report, or in the decision to submit the paper for publication.
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Contributors: SHB: Conceptualized and designed the study, analyzed, and interpreted data, and drafted the initial manuscript; VT: Conceptualized and designed the study, was involved in obtaining ethics approval, analyzed, and interpreted data and revised the manuscript; CG, IC: Conceptualized the study, enrolled patients and did data collection; CL: Conceptualized the study and provided critical review of the original and subsequent manuscript drafts. All authors approved the final manuscript as submitted.
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Ethics Clearance: The Sant Joan de Déu Research Foundation Ethics Committee; PIC-166-18, dated Jan 24, 2019.
Competing interests: None stated.
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Hernández-Bou, S., Trenchs, V., Guirado, C. et al. Procalcitonin as Point-of-Care Testing Modality for the Diagnosis of Pneumonia in Children With Influenza-like Illness. Indian Pediatr 61, 57–61 (2024). https://doi.org/10.1007/s13312-024-3089-0
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DOI: https://doi.org/10.1007/s13312-024-3089-0