title: Is procalcitonin a useful biomarker for the risk stratification of facial cellulitis?
abstract: BACKGROUND
  Facial cellulitis is an infectious disease that may require emergency surgical drainage based on clinical assessment. To date, no biological marker has been reported to be useful for risk stratification. Procalcitonin (PCT) is a diagnostic and prognostic sepsis biomarker. We aimed to study the usefulness of PCT dosage for the risk-stratification of facial cellulitis.
  
  
  METHODS
  This was a monocentric prospective study conducted in a referral center for maxillofacial emergencies. Patients with a diagnosis of facial cellulitis were included and underwent a PCT measurement at admission. The main criterion was the requirement for surgical drainage.
  
  
  RESULTS
  Seventy consecutive patients were included in a 7-months period, mean age 35 ± 14 years. Surgical drainage was required for 48 patients (68%). Serum PCT concentrations were strictly negative in most patients (median [IQR]: 0.05 μg/L [0.05; 0.10]). Only 6 patients (9%) had PCT values above the clinical threshold of 0.25 μg/L. At a threshold of 0.1 μg/L, PCT was 30% sensitive and 100% specific for surgical drainage requirement.
  
  
  CONCLUSIONS
  PCT level usually remains in a low range in facial cellulitis and seems to have a limited added value for risk stratification.
authors.affiliation: Oral and Maxillo-facial Surgery Department, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; Sorbonne Universités, UPMC Univ, Paris-06, Paris, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Bertolus
authors.affiliation: Oral and Maxillo-facial Surgery Department, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schouman
authors.affiliation: Emergency Department, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Aubry
authors.affiliation: Emergency Department, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; GRC-UPMC BIOSFAST, Sorbonne Universités, UPMC Univ, Paris-06, Paris, France. Electronic address: pierre.hausfater@aphp.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Hausfater
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D002481:Cellulitis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002116:Calcitonin
keywords: Emergency department; Facial cellulitis; Procalcitonin; Severity assessment