Procalcitonin in diagnosis of post-operative bacterial meningitis: a promising but limited role

Diagnostic Value of Procalcitonin for Bacterial Meningitis in Children: A Comparison Analysis Between Serum and Cerebrospinal Fluid Procalcitonin Levels

The aim of this study was to analyze and compare procalcitonin (PCT) levels in serum and cerebrospinal fluid (CSF) as tools for detecting bacterial meningitis (BM) in children. Serum and CSF PCT levels as well as albumin index (AI = CSF albumin/serum albumin × 1000) were measured from 29 BM, 25 viral meningitis (VM), and 47 non-meningitis patients. Differences between groups only for CSF PCT were significant. A stronger positive correlation between CSF PCT level and AI was observed in the BM patients ( R = 0.68, P < .001). As a predictor of BM, the area under the receiver operating characteristics curve for CSF PCT was greater than that of serum PCT (0.76 vs 0.67, P < .05) and a cutoff of ⩾0.085 ng/mL achieved 55.17% sensitivity and 95.83% specificity. High levels of CSF PCT may indicate loss of integrity of the blood-brain barrier; only CSF PCT has a diagnostic value for BM in children suspected meningitis.

Correlation between CD64 and PCT levels in cerebrospinal fluid and degree of hearing impairment sequelae in neonates with purulent meningitis

This study investigated the possible correlation between the degree of hearing impairment caused by neonatal purulent meningitis and the levels of CD64 and PCT in cerebrospinal fluid of patients, and assessed the prognostic value of such levels. We recorded data from 156 cases of neonatal purulent meningitis retrospectively. All the patients received brainstem response audiometry, and cerebrospinal fluid samples were collected within the first day after admission through lumbar puncture. Flow cytometry was used to detect CD64 levels and enzyme-linked fluorescent assay was used to detect PCT levels. The children with hearing impairment were followed up for 1 year and brainstem response audiometry was performed again in them. We found that 43.59% of the children showed different degrees of hearing impairment, and 55% of them did not fully recover. The levels of PCT and CD64 in cerebrospinal fluid of children with hearing impairment were significantly higher than those of children with normal hearing (P<0.01). The levels of PCT and CD64 in mild, moderate and severe hearing impaired children increased gradually with higher degrees of impairment, and the differences between groups were significant (P<0.01). During the follow-up, it was found that the levels of PCT and CD64 in children correlated well with the degree of hearing recovery, and the differences between groups were significant (P<0.01). In our study, approximately 1/4 children with purulent meningitis showed long-term hearing impairment. Based on our analyses, the levels of CD64 and PCT in cerebrospinal fluid can be used to predict the degree and long-term prognosis of hearing impairment caused by purulent meningitis in children.

Clinical importance of serum procalcitonin in ulcerative colitis patients

We have read with interest the recently published article entitled “Clinical significance of serum procalcitonin in patients with ulcerative colitis” by Koido et al. They aimed to investigate the association of procalcitonin with ulcerative colitis (UC) activity. They concluded that elevated procalcitonin levels were significantly correlated with UC activity. We would like to thank the authors for their comprehensive contribution.