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Service des maladies infectieuses, Département de médecine, BH 19-111 CHUV, 1011 Lausanne. James.Robinson@chuv.ch
Procalcitonin is a marker of severe bacterial infections in non-neutropenic patients. The goal of this review is to assess its utility in the management of neutropenic patients. A delayed treatment of infection in this setting results in severe morbidity and high mortality. As traditional diagnostic tools often fail to exclude infection when fever occurs, all these patients receive empirical antimicrobial therapies during long periods of time. Present knowledge suggests that procalcitonin may contribute to identify patients in whom 1) antibiotics could be stopped in the absence of bacterial infection, 2) investigations and adjustments of the antimicrobial therapy for persistent fever are needed. The use of procalcitonin for the management of febrile neutropenic patients should be studied prospectively.
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