Procalcitonin as a marker of bacterial infection in febrile neutropenic children

Since neutropenic patients with malignancies are at high risk of contracting life-threatening infections, reliable and readily available parameters to diagnosis or rule out infection are of utmost importance. The objective of the present study was to determine the accuracy of procalcitonin (PCT) compared with culture to predict bacterial infection in children with febrile neutropenia. Blood culture and serum procalcitonin level were investigated in all studied febrile neutropenic children. Bacterial infection was defined as children with positive blood cultures or serum procalcitonin level of >0.5ng/ml. The study population included 29 boys and 22 girls with the mean age (±standard deviation) of 6±3.5 years. PCT differed significantly between bacterimic and non-bacterimic episodes for the prediction of bacterimic patients. The associated positive predictive value (PPV) and negative predictive value (NPV) of procalcitonin test (in diagnosis of bacterial infection) were 50% and 97/4%, respectively. A rapid determination of procalcitonin concentration could be useful for early diagnosis of children with febrile neutropenia since the test showed an acceptable NPV.