J Korean Med Sci.  2009 Jun;24(3):398-402. 10.3346/jkms.2009.24.3.398.

Serum and Pleural Fluid Procalcitonin in Predicting Bacterial Infection in Patients with Parapneumonic Effusion

• Ko YC
• Wu WP
• Hsu CS
• Dai MP
• Ou CC
• Kao CH

• KMID: 1779154
• DOI: http://doi.org/10.3346/jkms.2009.24.3.398

Abstract

This study evaluated the value of procalcitonin (PCT) levels in pleural effusion to differentiate the etiology of parapneumonic effusion (PPE). Forty-one consecutive PPE patients were enrolled and were divided into bacterial and non-bacterial PPE. Blood and pleural effusion samples were collected for PCT measurement on admission and analyzed for diagnostic evaluation. PCT of pleural fluid was significantly increased in the bacterial PPE group (0.24 ng/mL) compared to the non-bacterial PPE group (0.09 ng/mL), but there was no significant difference for serum PCT. A PCT concentration of pleural fluid >0.174 ng/mL (best cut-off value) was considered positive for a diagnosis of bacterial PPE (sensitivity, 80%; specificity, 76%; AUC, 0.84). Pleural effusion PCT in the bacterial PPE is significantly different from those of the non-bacterial PPE and control groups, so the diagnostic use of PCT still warrants further investigation.

Keyword

Procalcitonin; Pleural Effusion; Pneumonia

MeSH Terms

Aged
Bacterial Infections/*diagnosis
Calcitonin/*analysis/blood
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Pleural Effusion/*diagnosis
Pneumonia/*diagnosis
Predictive Value of Tests
Protein Precursors/*analysis/blood
ROC Curve

Figure

• 

  Fig. 1 Comparison of pleural concentrations of procalcitonin among the bacterial parapneumonic effusion (PPE), non-bacterial PPE, and control groups (Bonferroni criteria of Mann-Whitney U test).

• 

  Fig. 2 Receiver-operating characteristic (ROC) curve analysis of pleural concentrations of procalcitonin and diagnosis of bacterial parapneumonic effusion.

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