Format

Send to

Choose Destination
J Infect. 2016 Jan;72(1):1-18. doi: 10.1016/j.jinf.2015.09.007. Epub 2015 Sep 30.

Utility of immune response-derived biomarkers in the differential diagnosis of inflammatory disorders.

Author information

1
Department of Internal Medicine, and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Internal Postal Code 463, PO box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: jaap.tenoever@radboudumc.nl.
2
Department of Internal Medicine, and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Internal Postal Code 463, PO box 9101, 6500 HB Nijmegen, The Netherlands.

Abstract

Differentiating between inflammatory disorders is difficult, but important for a rational use of antimicrobial agents. Biomarkers reflecting the host immune response may offer an attractive strategy to predict the etiology of an inflammatory process and can thus be of help in decision making. We performed a review of the literature to evaluate the diagnostic value of inflammatory biomarkers in adult patients admitted to the hospital with suspected systemic acute infections. Elevated procalcitonin (PCT) concentrations indicate a bacterial infection in febrile patients with an auto-immune disease, rather than a disease flare. CD64 expression on neutrophils can discriminate between non-infectious systemic inflammation and sepsis, and limited evidence suggests the same for decoy receptor 3. PCT is useful for both diagnosing bacterial infection complicating influenza and guiding antibiotic treatment in lower respiratory tract infections in general. In undifferentiated illnesses, increased CD35 expression on neutrophils distinguishes bacterial from viral infections. Compared to bacterial infections, invasive fungal infections are characterized by low concentrations of PCT. No biomarker predicting a specific infecting agent could be identified.

KEYWORDS:

Biomarkers; Diagnosis; Immunology; Non-infectious inflammatory disorder; Sepsis

PMID:
26429736
DOI:
10.1016/j.jinf.2015.09.007
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center