Role of procalcitonin and c-reactive protein levels: a diagnostic tool in lower respiratory tract infections

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Published Aug 16, 2016
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Vol. 94 No. 3 (2016): Issue Mar 2016

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Jihen Ben Amar
Haifa Zaibi
Kehna Bouzid
Saloua Azzabi
Mohamed Ali Bacca
Besma Dahari
Hichem Aouina

Abstract

Abstract:
Background: Conventional biomarkers lack sensitivity and specificity for acute pulmonary Community (PAC). Procalcitonin (PCT) has been described in the literature for its usefulness in the PAC. The aim of our work was to study the contribution of the PCT in the positive diagnosis of PAC and in the initial assessment of the severity and the interest of CRP and PCT to distinguish lung infections from tuberculous origin of the PAC.
Methods:
 Prospective study of 100 middle-aged 45 years [16-82], admitted to our clinic for evaluation of lung opacity some of the reason for consultation. All patients with antibiotics before admission were excluded. We studied the clinical, radiological, biological and bacteriological characteristics of patients.
 Results:
The rate of PCT was significantly higher in PAC compared to TBC (p <0.001). The values of CRP and PCT were correlated to changes in the PAC. The mean values of CRP and PCT were higher for the most severe PAC and the difference was statistically significant for CRP and PCT between the two (p =0.01). The cut-off of CRP and PCT could discriminate a PAC values were 35 mg / l and 0.12 ng /ml.
Conclusion:
The PCT is a good marker for diagnosis and the prognosis of PAC. It permits  to discriminate diagnosing CAP compared to tuberculosis.

Keywords:

protéine C-réactive, procalcitonine, pneumopathie aigue communautaire, tuberculose

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References

  1. Marrie TJ. Community-acquired pneumonia. Clin Infect Dis. 1994;18:501-13.
  2. Ishida T. Etiology of community-acquired pneumonia among adult patients in Japan. Jpn J Antibiot. 2000;53 Suppl B:3-12.
  3. Liam CK, Pang YK, Poosparajah S. Pulmonary tuberculosis presenting as community-acquired pneumonia. Respirology. 2006;11:786-92.
  4. Kiyan E, Kilicaslan Z, Gurgan M, Tunaci A, Yildiz A. Clinical and radiographic features of pulmonary tuberculosis in non-AIDS immunocompromised patients. Int J Tuberc Lung Dis. 2003;7:764-70.
  5. Lieberman D, Schlaeffer F, Porath A. Community acquired pneumonia in old age: a prospective study of 91 patients admitted from home. Age Ageing. 1997;26:69-75.
  6. Suzanne B, Cohen R, Nicholas P, Cucherat M, Perret GY. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med. 2006;34:1996-2003.
  7. De Werra I, Jaccard C, Corradin SB, et al. Cytokines, nitrite/ nitrate, soluble tumor necrosis factor receptors, and procalcitonin concentrations: comparisons in patients with septic shock, cardiogenic shock, and bacterial pneumonia. Crit Care Med. 1997;25:607-13.
  8. Polzin A, Pletz M, Erbes R, et al. Procalcitonin as a diagnostic tool in lower respiratory tract infections and tuberculosis. Eur Respir J. 2003;21:939-43.
  9. Schleicher GK, Herbert V, Brink A, et al. Procalcitonin and C Reactive protein levels in HIV-positive subjects with tuberculosis and pneumonia. Eur Respir J. 2005;25:688-92.
  10. Currie CSM, Floyd K, Williams BG, Dye C. Cost, affordability and cost effectiveness of strategies to control tuberculosis in countries with high HIV prevalence. BMC Public Health. 2005;5:130
  11. Lawn SD, Afful B, Acheampong JW. Pulmonary tuberculosis: diagnostic delay in Ghanaian adults. Int J Tuberc Lung Dis. 1998;2:635-40.
  12. Lin X, Chongsuvivatwong V, Lin L, Geater A, Lijuan R. Dose-response relationship between treatment delay of smear-positive tuberculosis patients and intra household transmission: a cross-sectional study. Trans R Soc Trop Med Hyg . 2008;102:797-804
  13. Rossato Silva D, Müller AM, Dalcin Pde T. Factors associated with delayed diagnosis of tuberculosis in hospitalized patients in a high TB and HIV burden setting: a cross-sectional study. BMC Infect Dis. 2012;12:57
  14. Saffron N, Heldal E, Pavlovic S, Vuckovic D, Boe J. Why do our patients die of active tuberculosis in the era of effective therapy? Tuber and Lung Dis.1994;75:329-33.
  15. Madebo T, Lindtjorn B. Delay in treatment of pulmonary Tuberculosis: An analysis of symptom duration among Ethiopian patients. Medscape General Medicine.1999; E6.
  16. El-Sony A, Enarson D, Khamis A, Baraka ON june G. Relations of grading of sputum smears with clinical features of tuberculosis in patients in routine practice in Sudan. Int J Tuberc Lung Dis. 2002;6:91-7.
  17. Ugajin M, Miwa S, Shira M et al. Usefulness of serum procalcitonin levels in pulmonary tuberculosis. Euro Respir J. 2011;37:371-75
  18. Kang YA, Kwon SY, Yoon HI, Lee JH, Lee CT. Role of C-reactive protein and procalcitonin in differentiation of tuberculosis from bacterial community acquired pneumonia. Korean J Intern Med. 2009; 24:337-42
  19. Christ-Crain M, Jaccard-Stolz D, Bingisser R et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet. 2004; 363:600-7
  20. Müller B, Schuetz Ph, Christ-Crain M. Procalcitonine. Nova Forum Med Suisse. 2008;8 :288-390.