title: Procalcitonin concentrations in patients with neutropenic fever.
abstract: To assess the usefulness of markers of inflammation in distinguishing bacterial infection from severe systemic nonbacterial inflammation, concentrations of procalcitonin, neopterin, endotoxin, tumor necrosis factor, and interleukin-6 were measured in 28 neutropenic patients at the onset of fever and twice thereafter at 4 h intervals. Infection was found in 11 patients, and 17 patients had fever of undetermined origin. The procalcitonin concentration increased rapidly in patients with infection: the response was detectable within 8 h of the onset of fever. Procalcitonin is a specific but not a sensitive marker of infection in patients with neutropenic fever. Its poor sensitivity was related to an absent or delayed response in patients with gram-positive infections. Considerable overlap between infected and noninfected patients was found in levels of endotoxin, tumor necrosis factor, and interleukin-6.
authors.affiliation: Critical Care Research Program, Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Ruokonen
authors.forename: T
authors.initials: T
authors.lastname: Nousiainen
authors.forename: K
authors.initials: K
authors.lastname: Pulkki
authors.forename: J
authors.initials: J
authors.lastname: Takala
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D004731:Endotoxins / Q000097:blood; D005335:Fever of Unknown Origin / Q000097:blood* / Q000150:complications / Q000209:etiology; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D019798:Neopterin / Q000097:blood; D009503:Neutropenia / Q000097:blood* / Q000150:complications; D011498:Protein Precursors / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D004731:Endotoxins; D015850:Interleukin-6; D011498:Protein Precursors; D014409:Tumor Necrosis Factor-alpha; D019798:Neopterin; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide