The potential role of procalcitonin in the emergency department management of febrile young adults during a sustained meningococcal epidemic

Emergency Medicine Australasia : EMA
Simon A BugdenGraham D Mills

Abstract

To prospectively investigate the diagnostic characteristics of procalcitonin as an aid in the diagnosis of meningococcal disease in febrile young adults presenting to the Waikato Hospital emergency department during a sustained meningococcal epidemic. The study population were emergency department patients aged 14-40 years presenting with either a temperature > or = 38.0 degrees C without an obvious focus of infection, or symptoms consistent with meningococcal disease. All had procalcitonin levels, N. meningitidis PCR, blood +/- CSF cultures. One hundred and eighty-three patients presented with undifferentiated febrile illness over a 9 month study period. Nine were subsequently shown to have meningococcal disease. A positive procalcitonin (> or = 0.5 ng/mL) had a sensitivity of 100% (CI 66.4-100), specificity 89% (CI 83.1-93.1), negative predictive value 100% (CI 97.6-100) and positive predictive value 32% (CI 15.9-52.4) for meningococcal disease. The finding of a procalcitonin level > or = 0.5 ng/mL in young adults with undifferentiated fever indicates an increased chance that the presenting illness may be meningococcal disease. In New Zealand's continuing meningococcal epidemic empirical antibiotics should be strongly conside...Continue Reading

References

Jan 1, 1983·The Journal of Pediatrics·B DashefskyJ O Klein
Jan 1, 1993·Scandinavian Journal of Infectious Diseases·L O HanssonL Lindquist
Nov 16, 1996·BMJ : British Medical Journal·F A RiordanC A Hart
Oct 6, 1997·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R F KornelisseR de Groot
Oct 24, 1998·Journal of Accident & Emergency Medicine·S NadelM Levin
Aug 18, 1999·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·A ViallonJ C Bertrand
Oct 16, 1999·Archives of Disease in Childhood·M HatherillI A Murdoch
Feb 26, 2000·Annals of Emergency Medicine·J E Tintinalli
Jul 13, 2000·Critical Care Medicine·S SchwarzW Hacke
Aug 26, 2000·The Pediatric Infectious Disease Journal·D Gendrel, C Bohuon
Mar 7, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·P HausfaterB Riou
Jun 28, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Catherine ChirouzeBruno Hoen
Jul 20, 2002·International Journal of Antimicrobial Agents·E D CarrolC A Hart
Oct 23, 2002·Archives of Disease in Childhood·F LeclercC Fourier
Nov 1, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thibaud d'EscrivanLaurent Robriquet
Nov 5, 2002·Intensive Care Medicine·D C M Van der KaayJ A Hazelzet
Mar 11, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jose Luis Villanueva, Richardas J Cervin
Mar 11, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Eric NylenRichard Snider
Mar 11, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jaap T van Dissel
Mar 11, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anne-Lise DebardGuillaume Monneret
Mar 27, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Yong Y HanJoseph A Carcillo
May 17, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Francis LeclercOdile Noizet

❮ Previous
Next ❯

Citations

Aug 10, 2006·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·G D MillsP Reeve
Mar 8, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Christoph R SinningUNKNOWN AtheroGene Study Investigators
Dec 13, 2006·Annals of Emergency Medicine·Alan E JonesJeffrey A Kline
Jun 15, 2011·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Fauzia PaizeCheng-Hock Toh
Sep 23, 2006·Expert Review of Vaccines·Harry L KeyserlingGregory P Gilmet
Sep 22, 2005·Current Opinion in Critical Care·Michael Meisner
Dec 8, 2010·Expert Review of Anti-infective Therapy·Thomas W BourkeMichael D Shields
Apr 14, 2005·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·J A Soult Rubio, M Muñoz Sáez

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.