Procalcitonin Level and Severe Septic Infection in lmmunocompromised Patients _, • with Haematological Malignancies

Abstract

A prospective study was performed to assess the usefulness of markers of inflammation in distinguishing bacterial and fungal infection from severe systemic noninfectious inflammation, concentrations of Procalcitonin, which is a 116 amino acid propeptide of calcitonin was measured in 36 febrile neutropenic patients with baematological malignancies as a study group and 10 afebrile non-neutropenic patients under follow up after ending chemotherapy as a control group from pediatric unit of the medical oncology department in the National Cancer Institute (NCI), Cairo University during the period between December 2000 and January 2001. Blood samples for analysis of levels of Procalcitonin were collected before, at 4 hours and 8 hours after the start of antimicrobial therapy.

Infection was found in 26 patients, Bacteraemia was established in

16 patients, 10 patients of them had blood culture positive for gram­ negative organisms, other 6 patients had growth of gram-positive organisms, 4 patients had urinary tract infection detected by urine culture, 6 patients had positive stool culture, at the last there were 12 patients had fungaemia detected by growth of fungal colonies in the blood cultures and by persistence of fever and neutropenia for more than 7 days in spite of administration of intravenous antibiotics, one patient had bronchopneumonia documented by chest x-ray finding and 10 patients had fever of undetermined origin.

The procalcitonin concentrations were higher in the study group compared with the control group, throughout the study.