J Korean Neurosurg Soc.  2015 Sep;58(3):271-275. 10.3340/jkns.2015.58.3.271.

Clinical Value of Procalcitonin in Patients with Spinal Infection

• Jeong DK
• Lee HW
• Kwon YM

• KMID: 2191382
• DOI: http://doi.org/10.3340/jkns.2015.58.3.271

Abstract

OBJECTIVE
This study was designed to evaluation the diagnostic value of procalcitonin (PCT) in patients with spinal infection, compare to the classical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count.
METHODS
All patients who were diagnosed as a spinal infection between January, 2013 and July, 2014 were included in this study. Serum PCT, CRP, ESR, and WBC count were checked at initial hospital visit and once a week serially until they were discharged. Patient's medical history, causes and pathogens of spinal infection were reviewed.
RESULTS
Total 34 (16 men, 18 women) patients were included in this study. Mean age of the patients was 65.6 year-old. Causes of spinal infection were pain block procedure (14, 41.2%) and post-operation (5, 14.7%). Out of 25 patients who showed elevated initial serum PCT level, 20 patients (80%) had a combined systemic infection. 14 patients (6.7%) had a sepsis, 3 patients (14.2%) had a urinary tract infection and 2 (9.6%) had a pneumonia. 14 patients (41.2%) showed elevation of serum PCT level during treatment. Among them, 9 patients (64.3%) had a combined infection such as sepsis and urinary tract infection.
CONCLUSION
Serum CRP showed more sensitivity compared to serum PCT in patients with spinal infection. Patients with spinal infection who showed elevated serum PCT level should be investigated for combined infection and proper antibiotics should be applied.

Keyword

Procalcitonin; C-reactive protein; Pyogenic; Spondylitis; Discitis

MeSH Terms

Anti-Bacterial Agents
Biomarkers
Blood Sedimentation
C-Reactive Protein
Discitis
Humans
Leukocytes
Male
Pneumonia
Sepsis
Spondylitis
Urinary Tract Infections
Anti-Bacterial Agents
C-Reactive Protein

Figure

• 

  Fig. 1 Serum PCT level (A) and CRP level (B) in patients without combined infection, with localized combined and with systemic combined infection. Median PCT level was 0 ng/mL in patients without combined infection and the result was increased to 0.31 ng/mL in patients with localized combined infection, to 4.9 ng/mL in patients with systemic combined infection (p=0.01). Median CRP was 5.57 mg/dL in patients without combined infection and it increased to 14.18 in patients with localized combined infection, to 15.97 in patients with systemic combined infection (p=0.055). Serum PCT hardly increased in cases of spinal infection without combined infection. PCT : procalcitonin, CRP : C-reactive protein.

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