title: [Procalcitonin as a marker for severe sepsis in an immunosuppressed patient].
abstract: A 22 year old female was admitted to the emergency department with high fever up to 41,5 degrees C, tachycardia, and arterial hypotension. Clinically, she presented with bilateral pulmonary coarse crackles. Diagnosis on admission was pneumonia with septic shock. Intriguingly, procalcitonin (PCT) was increased early, reaching up to 435 ng/mL, while C-reactive protein levels were only moderately increased, with several days delay. The sepsis was originated from a multi-resistant pseudomonas aeruginosa pneumonia. Remarkably, the course of PCT levels reflected the severity of septic shock in that it paralleled noradrenaline demand. Ten months previously, the patient had been diagnosed with acute disseminated brainstem encephalitis (ADEM), and had received two cycles of intravenous cyclophosphamide. Our case illustrates that PCT is an early marker for sepsis and it indicates that PCT may also be a valuable marker for the severity of sepsis in immunosuppressed patients.
authors.affiliation: Klinik für Neurologie, Friedrich-Schiller-Universität Jena, Jena. Hubertus.Axer@med.uni-jena.de
authors.forename: H
authors.initials: H
authors.lastname: Axer
authors.forename: M
authors.initials: M
authors.lastname: Wohlfarth
authors.forename: M
authors.initials: M
authors.lastname: Meisner
authors.forename: S
authors.initials: S
authors.lastname: Finn
authors.forename: A
authors.initials: A
authors.lastname: Ragoschke-Schumm
authors.forename: H-J
authors.initials: HJ
authors.lastname: Mentzel
authors.forename: O W
authors.initials: OW
authors.lastname: Witte
authors.forename: S
authors.initials: S
authors.lastname: Isenmann
mesh_terms: D000328:Adult; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D009638:Norepinephrine / Q000097:blood; D018410:Pneumonia, Bacterial / Q000097:blood; D011498:Protein Precursors / Q000097:blood*; D011552:Pseudomonas Infections / Q000097:blood; D018805:Sepsis / Q000175:diagnosis* / Q000209:etiology; D012772:Shock, Septic / Q000097:blood
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide; D009638:Norepinephrine