Résumé
L’identification et l’évaluation de la gravité des états septiques aux urgences est un enjeu majeur. Les paramètres biologiques usuels comme l’hémogramme et la protéine C réactive (CRP) ne sont pas suffisamment sensibles et spécifiques. La procalcitonine (PCT) est un biomarqueur d’infection dont les concentrations sériques augmentent de manière spécifique dans le sérum au cours des infections bactériennes ou parasitaires systémiques. Inversement, la PCT sérique ne varie pas ou peu dans les syndromes inflammatoires non infectieux et les infections virales. De plus, la valeur absolue de la PCT est proportionnelle à la gravité de l’état septique. Son utilisation aux urgences trouve son indication préférentielle dans l’aide à l’antibiothérapie des suspicions d’infection respiratoire et dans le diagnostic d’un état septique en l’absence de foyer infectieux clinique patent. Le dosage de la PCT contribue également à aider le clinicien à apprécier la gravité des états septiques.
Abstract
The identification and accurate evaluation of the severity of sepsis are the major concern in the emergency room. The usual biological parameters such as hemogram and C-reactive protein are not enough sensitive and specific. Procalcitonin (PCT) is a biomarker of infection. PCT serum levels rise specifically in bacterial or parasitic systemic infections. Conversely, PCT concentrations are not detected or only slightly elevated in viral infections and non-infectious inflammatory conditions. Moreover, PCT crude value is related to the severity of infection. PCT dosage is particularly useful in the emergency room to help the physician in the initiation of antibiotics in patients suspected of having a lower respiratory tract infection, and for the diagnosis of sepsis without a source of infection. PCT dosage also contributes to the accurate evaluation of the severity of sepsis.
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Hausfater, P. Procalcitonine et infection. Ann. Fr. Med. Urgence 1, 206–212 (2011). https://doi.org/10.1007/s13341-011-0048-x
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DOI: https://doi.org/10.1007/s13341-011-0048-x