Service de Médecine Interne, Centre de Référence de la Drépanocytose Adulte, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 4 rue de la Chine, Paris cedex 20, France.
Infection. 2011 Feb;39(1):41-5. doi: 10.1007/s15010-010-0072-6. Epub 2011 Jan 11.
Fever is often present during painful vaso-occlusive crisis (VOC) in sickle-cell disease (SCD), but does not always indicate infection. The aim of our study was to test procalcitonin as a marker of invasive bacterial infection in VOC. Consecutive SCD adults hospitalized for VOC were included. Data were collected at admission and within 24 h after the onset of fever. We distinguished patients with clinically defined and microbiologically documented invasive bacterial infection from patients with no evidence of invasive bacterial infection and who fared well without antibiotics. One hundred and twelve patients were enrolled (61% females, median age 23 years, 88% homozygous SCD). All patients with procalcitonin (PCT) level ≥1 μg/L had an invasive bacterial infection, but two patients (33%) with an invasive bacterial infection had a PCT level <1 μg/L. High levels of PCT indicate invasive bacterial infection. However, a single low PCT level without follow-up measurement cannot rule out an invasive bacterial infection and should not withhold the prescription of antibiotics.
发热在镰状细胞病（SCD）患者血管阻塞性危象（VOC）期间很常见，但并不总是提示感染。我们的研究目的是检测降钙素原是否可作为 VOC 中侵袭性细菌感染的标志物。连续纳入因 VOC 住院的 SCD 成年患者。数据在发热开始时和 24 小时内采集。我们将有临床确诊和微生物学确诊的侵袭性细菌感染患者与无侵袭性细菌感染证据且无抗生素治疗的患者进行区分。共纳入 112 例患者（61%为女性，中位年龄 23 岁，88%为纯合子 SCD）。所有 PCT 水平≥1μg/L 的患者均有侵袭性细菌感染，但有 2 例（33%）有侵袭性细菌感染的患者 PCT 水平<1μg/L。高 PCT 水平提示侵袭性细菌感染。然而，单次低 PCT 水平且无后续测量不能排除侵袭性细菌感染，不应拒绝开抗生素。
