Diagnostic value of serum procalcitonin as a marker of bacterial infection in cirrhotic patients with fever

Abstract EN

( To evaluate the value ofprocalcitonin in diagnosis of the infectious aetiology of fever in patients with liver cirrhosis this study was done.

The study included 41 patients with liver cirrhosis of different grades of severity, 31 of them presented by fever and 10 without fever (considered as control group).

After thorough investigations the focal sites of infection were localised in 20 (64.5%) patients (respiratory tract infection in 10 patients, urinary tract infection in 4 cases and spontaneous bacterial peritonitis in 6 cases) and no specific site was detected in 11(35.5%) of patients.

Blood culture was positive only in 4 cases (12.9%) and all were Gm-ve bacilli.

A highly significant difference in the mean serum level of procalcitonin (PCT) between cirrhotic patients with fever and those without fever was found.

The same was true for serum C-reactive protein (CRP) but no statistical difference was found between the two groups regarding leucocytosis.

PCT shows 100% sensitivity and 80% specificity in diagnosis of infectious aetiology of fever in patients with liver cirrhosis.

From this we conclude that PCT has a diagnostic value in differentiating the infectious aetiology of fever in patients in the liver cirrhosis and fever.

This enables us to start early treatment in those immunocompromised patients.