Assessment of Procalcitonin as Diagnostic Marker in Children with Neutropenic Fever

INTRODUCTION: The aim of this study is to predict the usefulness of procalcitonin (PCT) for diagnosis of systemic and bacterial infections in children with neutropenic fever.
METHODS: In this study 46 neutropenic fever attacks of the 32 cancer patients were evaluated. Newly diagnosed 35 cancer patients were selected as controls. Serum levels of PCT and CRP (C- reactive protein) were determined on the first and third days of fever and at the end of the antimicrobial therapy in study group. Neutropenic fever episodes were classified as fever of unknown origin (FUO), microbiologically and clinically documented infection (MDI, CDI). MDI were further subdivided into two groups as systemic and localized infection.
RESULTS: Serum levels of PCT were highest on the first day of neutropenic fever in MDI group. The levels of PCT were higher in systemic infections than localized ones. There was no difference for the serum levels of CRP in FUO, CDI and MDI or systemic and localized infections. The PCT levels rapidly decreased to the normal range by resolution of fever with successful antimicrobial therapy.
DISCUSSION AND CONCLUSION: We conclude that serial measurement of serum PCT levels is more sensitive and specific than that of CRP for diagnosis and sequential assessment of febrile neutropenic episodes.