title: Procalcitonin as an early diagnostic marker for ventriculoperitoneal shunt infections.
abstract: BACKGROUND
  Procalcitonin (PCT) has been considered a more reliable marker than others because of its specificity for bacterial infection.
  
  
  METHODS
  Case report and review of the literature.
  
  
  RESULTS
  A 50-year-old male was diagnosed with subarachnoid hemorrhage, intraventricular hemorrhage, and intracerebral hemorrhage. We performed a ruptured aneurysm clipping and left unilateral external ventricular drainage. We also performed ventriculoperitoneal (VP) shunt placement in the course; however, VP shunt infection was indicated by fever, increased C-reactive protein concentration and leukocytosis. The cerebrospinal fluid culture showed methicillin-resistant Staphylococcus epidermidis but the serum PCT concentration was quite low.
  
  
  CONCLUSIONS
  Although PCT is considered a more reliable serological marker of bacterial meningitis in several reports, the serum PCT concentration did not reflect the bacterial VP shunt infection that was present in our case.
authors.affiliation: 1 Department of Neurosurgery, Saitama Municipal Hospital , Saitama, Japan .
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tomio
authors.forename: Takenori
authors.initials: T
authors.lastname: Akiyama
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Shibao
authors.forename: Kazunari
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery; D015415:Biomarkers / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism*; D015740:Calcitonin Gene-Related Peptide; D042241:Early Diagnosis; D006801:Humans; D020300:Intracranial Hemorrhages / Q000601:surgery; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D011498:Protein Precursors / Q000378:metabolism*; D013203:Staphylococcal Infections / Q000175:diagnosis*; D013212:Staphylococcus epidermidis; D013530:Surgical Wound Infection / Q000175:diagnosis*; D017287:Ventriculoperitoneal Shunt
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide