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

ABSTRACT

This study was done to evaluate the value of procalcitonin in the diagnosis of the infectious etiology of fever in patients with liver cirrhosis. 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 a control group]. After thorough investigations, the focal sites of infection were localized in 20 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 patients. Blood culture was positive only in four cases and all were Gram -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 showed 100% sensitivity and 80% specificity in the diagnosis of infectious etiology of fever in patients with liver cirrhosis. It was concluded that PCT has a diagnostic value in differentiating the infectious etiology of fever in patients with liver cirrhosis and fever. This allows to start early treatment in those immunocompromised patients