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Kim, Kim, Lee, Lee, Ham, Cho, Jeong, Lee, and Hwang: Measuring Serum Procalcitonin in Patients with Fever in the ICU to Differentiate Infectious Causes from Non-Infectious Causes
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(1): 20-25.

Published online: 31 July 2006

DOI: https://doi.org/10.4046/trd.2006.61.1.20

Measuring Serum Procalcitonin in Patients with Fever in the ICU to Differentiate Infectious Causes from Non-Infectious Causes

Ho Cheol Kim, M.D., Kwang Min Kim, M.D., Sang Min Lee, M.D., Seung Jun Lee, M.D., Hyun Seok Ham, M.D., Yu Ji Cho, M.D., Yi Yeong Jeong, M.D., Jong Deok Lee, M.D., Young Sil Hwang, M.D.

Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea.

Address for correspondence: Ho Cheol Kim, M.D. Department of Internal Medicine, College of Medicine, Gyeongsang National University. 92 Chilam Dong, Jinju, 660-751, Korea. Phone: 055-750-8684, Fax: 055-758-9122, hochkim@gshp.gsnu.ac.kr

Received 21 February 2006       Accepted 29 June 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Although fever is one of the most common and challenging problem in intensive care medicine(ICU), it is difficult to distinguish between infectious and non-infectious causes. Procalcitonin(PCT) has recently been reported to be an indicator of various infectious diseases. This study examined whether or not measuring the serum PCT level in patients with fever in the ICU can help distinguish fevers with infectious causes from those with non-infectious causes.

Methods

ICU patients with fever at 38℃ or over from March to August 2005 were prospectively enrolled. The cause of the fever was identified by the culture results and clinical course. The leukocytes, CRP, PCT, IL-6, and TNF-α in the fever patients with infectious and non-infectious causes were compared, and the PCT level in the patients with fever in the ICU were compared with those without fever.

Results

1) 42 patients were enrolled and 46 cases of fever were analyzed. 26 cases were considered to be infectious, while 13 cases were considered to be non-infectious. 7 cases were found to have no clear causes. 2) There were no significant differences in the degree of fever, leukocytes count, CRP, IL-6, and TNF-α levels in the patiemts with infectious and non-infectious causes. 3) The serum PCT level was higher in those with infectious causes than in those with non-infectious causes (15.1±32.57ng/mL vs 2.68±3.63ng/mL) but there was no statistical significance (p=0.06). 4) The serum PCT level of the ICU patients with fever was significantly higher than in those without fever (10.94±27.15ng/mL vs 0.45±0.49ng/mL) (p=0.02).

Conclusion

The serum PCT cannot be used to distinguish the fever in ICU patients with infectious causes from that with non-infectious causes.

Keywords: Procalcitonin, Fever, ICU

Figures and Tables

Table 1
Infectious cause of fever (n=26)
trd-61-20-i001
Table 2
Non-infectious cause of fever (n=13)
trd-61-20-i002
Table 3
Temperature, WBC count, CRP, IL-6 and TNF-α in different study population
trd-61-20-i003

Values are expressed as mean ± standard deviation. WBC = White blood cell; CRP = C-reactive protein; IL = Interleukin; TNF = tumor necrosis factor, PCT = procalcitonin

***p<0.05 compared to critically ill patients without fever.

Notes

Acknowledgement : This study was supported by Gyeongsang National University Hospital Research Funds in 2005.

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