title: Serum procalcitonin levels in patients with primary pulmonary coccidioidomycosis.
abstract: BACKGROUND
  The serum procalcitonin assay has emerged as a promising biomarker to distinguish between bacterial and viral respiratory tract infections but has not been used to differentiate coccidioidomycosis from bacterial infection. A correlation between procalcitonin serum levels and coccidioidomycosis has never been reported.
  
  
  OBJECTIVE
  To determine any association between serum procalcitonin levels and primary pulmonary coccidioidomycosis.
  
  
  METHODS
  We identified and enrolled 20 immunocompetent patients with symptomatic primary pulmonary coccidioidomycosis of < 8 weeks' duration and performed a one-time procalcitonin assay, with a cutoff of < 0.25 μg/L indicating a nonbacterial infection.
  
  
  RESULTS
  Nineteen of 20 patients (95%) had serum procalcitonin of < 0.25 μg/L. The median procalcitonin level was 0.05 μg/L (range, < 0.05-0.87 μg/L; interquartile range, 0.05-0.05 μg/L). Sixteen of 20 patients (80%) had undetectable procalcitonin of < 0.05 μg/L. The four patients with detectable procalcitonin had a median value of 0.2 μg/L (range, 0.09-0.87 μg/L).
  
  
  CONCLUSIONS
  In this pilot study, procalcitonin was not elevated in immunocompetent patients with primary pulmonary coccidioidomycosis at a median of 32 days after symptom onset. Larger prospective studies are needed to confirm this finding.
authors.affiliation: 1 Departments of Internal Medicine and.
authors.forename: Kenneth K
authors.initials: KK
authors.lastname: Sakata
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Grys
authors.forename: Yu-Hui H
authors.initials: YH
authors.lastname: Chang
authors.forename: Holenarasipur R
authors.initials: HR
authors.lastname: Vikram
authors.forename: Janis E
authors.initials: JE
authors.lastname: Blair
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003047:Coccidioidomycosis / Q000097:blood* / Q000382:microbiology; D005260:Female; D006023:Glycoproteins; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000382:microbiology; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D006023:Glycoproteins; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: coccidioidomycosis; community-acquired pneumonia; immunocompetent; procalcitonin; respiratory tract infections