Department of Hematology, All India Institute of Medical Sciences (A.I.I.M.S), New Delhi, India.
Department of Hematology, All India Institute of Medical Sciences (A.I.I.M.S), New Delhi, India.
Blood Cells Mol Dis. 2020 Sep;84:102445. doi: 10.1016/j.bcmd.2020.102445. Epub 2020 May 14.
Febrile neutropenia is a common cause in morbidity and mortality during treatment of hematological neoplasms.
Subjects included all cases admitted under hematology department with febrile neutropenia from February to June 2018. Each febrile episode was investigated by standard investigations (Blood culture, Chest x ray etc.); Procalcitonin (PCT) and c reactive protein (CRP) was sent at fever onset 0, 24, 48 h, day 7 and day 14.
Data was analyzed for 52 febrile episodes in 50 patients. PCT cut off value at 24 h of ≤1.2 ng/ml had a sensitivity and specificity of 62.5% and 87.5% for discriminating Invasive fungal infection (IFI) and Microbiologically documented infection (MDI) (p = 0.033). PCT had a negative predictive value of 70% for the diagnosis of IFI as compared to MDI. CRP cut off >160 mg/dl at 48 h was suggestive of fever due to fungal infection with a sensitivity of 100%, specificity of 48%, PPV of 33.3% and NPV of 100%. CRP at 24 and 48 h of fever was useful to distinguish non-infectious causes of fever from infectious causes.
PCT at 24 h and CRP at 48 h was useful in identifying fungal infection. CRP was a better marker when compared to PCT for identifying disease fever.
发热性中性粒细胞减少症是血液系统恶性肿瘤治疗过程中发病率和死亡率的常见原因。
本研究纳入了 2018 年 2 月至 6 月期间血液科因发热性中性粒细胞减少症住院的所有患者。对每个发热事件均通过标准检查（血培养、胸部 X 线等）进行调查；在发热发作时 0、24、48 小时、第 7 天和第 14 天分别送检降钙素原（PCT）和 C 反应蛋白（CRP）。
对 50 例患者的 52 个发热事件进行了数据分析。24 小时时 PCT 值≤1.2ng/ml 的截断值对鉴别侵袭性真菌感染（IFI）和微生物学确诊感染（MDI）的敏感性和特异性分别为 62.5%和 87.5%（p=0.033）。与 MDI 相比，PCT 对 IFI 的阴性预测值为 70%。48 小时时 CRP 值>160mg/dl 提示真菌感染引起的发热，其敏感性为 100%，特异性为 48%，阳性预测值为 33.3%，阴性预测值为 100%。发热时的 24 小时和 48 小时 CRP 有助于区分发热的非感染性原因和感染性原因。
24 小时时的 PCT 和 48 小时时的 CRP 有助于识别真菌感染。与 PCT 相比，CRP 是识别疾病性发热的更好标志物。
