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Ann Am Thorac Soc. 2014 Oct;11(8):1239-43. doi: 10.1513/AnnalsATS.201404-180BC.

Serum procalcitonin levels in patients with primary pulmonary coccidioidomycosis.

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1
1 Departments of Internal Medicine and.

Abstract

RATIONALE:

The serum procalcitonin assay has emerged as a promising biomarker to distinguish between bacterial and viral respiratory tract infections but has not been used to differentiate coccidioidomycosis from bacterial infection. A correlation between procalcitonin serum levels and coccidioidomycosis has never been reported.

OBJECTIVE:

To determine any association between serum procalcitonin levels and primary pulmonary coccidioidomycosis.

METHODS:

We identified and enrolled 20 immunocompetent patients with symptomatic primary pulmonary coccidioidomycosis of < 8 weeks' duration and performed a one-time procalcitonin assay, with a cutoff of < 0.25 μg/L indicating a nonbacterial infection.

MEASUREMENTS AND MAIN RESULTS:

Nineteen of 20 patients (95%) had serum procalcitonin of < 0.25 μg/L. The median procalcitonin level was 0.05 μg/L (range, < 0.05-0.87 μg/L; interquartile range, 0.05-0.05 μg/L). Sixteen of 20 patients (80%) had undetectable procalcitonin of < 0.05 μg/L. The four patients with detectable procalcitonin had a median value of 0.2 μg/L (range, 0.09-0.87 μg/L).

CONCLUSIONS:

In this pilot study, procalcitonin was not elevated in immunocompetent patients with primary pulmonary coccidioidomycosis at a median of 32 days after symptom onset. Larger prospective studies are needed to confirm this finding.

KEYWORDS:

coccidioidomycosis; community-acquired pneumonia; immunocompetent; procalcitonin; respiratory tract infections

PMID:
25168059
DOI:
10.1513/AnnalsATS.201404-180BC
[Indexed for MEDLINE]

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