Diagnostic and prognostic significance of procalcitonin in septicemia

Azhar Ali Khan, Reeta Singh, Pavan Kumar Singh


Background: Sepsis is a major cause of morbidity and mortality. Early diagnosis and treatment with adequate antimicrobial therapy are essential for successful treatment. Despite the use of available treatment modalities mortality in sepsis remains high, often due to delayed diagnosis and treatment.

Methods: A total of 60 patients were enrolled from Nehru Hospital, B.R.D. Medical College, Gorakhpur during the study period July 2013 to July 2014. All the patients were subjected to detailed clinical examination and investigations.  Patient’s clinical profile, progression of disease and outcome were recorded. PCT and various other relevant factors were measured in all study subjects. The study was designed to assess the levels of serum PCT in patients with septicemia and to see whether serum PCT level correlates with severity of septicemia and survival outcome.

Results: Procalcitonin is a useful marker for severity of infection. High procalcitonin level is highly specific for infection. Low procalcitonin level cannot be used safely to exclude the presence of infection. Higher level of serum procalcitonin predicts mortality better than other parameters available.

Conclusions: From present study we can conclude that although sepsis is mainly a clinical diagnosis and its severity can be assessed by scores like APACHE II, but serum procalcitonin is a good marker for the assessing severity of the sepsis. Serum procalcitonin can aid in early diagnosis as it appears in blood earlier than other markers.



Full Text:



Carcillo JA, Cunnion RE. Septic shock. Crit care clin. 1997;13(3):553-74.

Volante E, Moretti S, Pisani F, Bevilacqua G. Early diagnosis of bacterial infection in the neonate. J Matern Fet Neonat Med. 2004;16(2):13-6.

Carlet J. Rapid diagnostic methods in the detection of sepsis. Infect Dis Clin North Am. 1999;13:483-94.

Moscovitz H, Shofer F, Mignott H, Berhrman A. Plasma cytokine determinations in emergency departments as a predictor of bacteraemia and infectious disease severity. Crit Care Med. 1994;22(7):1120-7.

Terregnio CA, Lopez BL, Karras DJ. Endogenous mediators in emergency department patients with sepsis: Are levels associated with progression to severe sepsis and death? Ann Emerg Med. 2000;35:26-34.

Matson A, Soni N, Sheldon J. C- reactive protein as a diagnostic test of sepsis in critically ill patients. Anaesth Intens Care. 1991;19:182-6.

Poova P, Almeida E, Moreira P, Fernandes A. C- reactive protein as an indicator of sepsis. Intens care med. 1998;24:1052-6.

Ugerte H, Silva E, Mercan D, De Mendonca A, Vincent JL. Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med. 1999;27:498-504.

Muller B, Becker KL, Schachinger H, Rickenbacher PR. Calcitonin precursors are reliable marker of sepsis in a medical intensive care unit. Crit Care Med. 2000;28:977-83.

De Werra I, Jaccard C, Corradin SB, Chioleo R. Procalcitonin as a diagnostic tool in lower respiratory tract infections and tuberculosis. Eur Respir J. 2003;21:939-43.

Assicot M, Nylen ES, Jordan MH. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet. 1993;347:518-9.

Rey C, Arcos ML, Coneha A, Mendina A. Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children. Intens Care Med. 2007;33(3):477-84.

Simon L, Gauvin F, Amre DK, Sint-Louis P. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection. A systemic review and meta- analysis. Clin Infect Dis. 2004;39:206-7.

Becker KL, Snider R, Nylen ES. Procalcitonin assay in systemic inflammation, infection, and sepsis: clinical utility and limitations. Crit Care Med. 2008;36:941-52.

Kibe S, Adams K. Diagnostic and prognostic biomarkers of sepsis in critical care, J Antimicrob Chemother. 2011;66(2):ii33-ii40.