ELEVATED SERUM PROCALCITONIN LEVELS IN PATIENTS WITH MELIOIDOSIS

The prognostic value of serum procalcitonin levels in 43 patients with acute melioidosis, an infection with a wide range of clinical manifes tations, was assessed. In eight patients with mild localized infection s, the median procalcitonin levels were 0.13 ng/mL (range, 0.02-0.46 n g/mL), which were similar to those in 19 healthy controls (median, 0.0 7 ng/mL; range, 0.03-0.15 ng/mL). In the patients with severe infectio ns, the initial procalcitonin levels were significantly higher in the patients who died (median, 350 ng/mL; range, 63-3,538 ng/mL) than in t he survivors (median, 19 ng/mL; range, 0.55-387 ng/mL) (P < .0001); 16 of 19 patients with procalcitonin levels of, >100 ng/mL died, compare d with 2 of 16 patients with levels of <100 ng/mL (relative risk, 6.7; 95% confidence interval, 1.8-25; P = .0001). In those patients who su rvived, the subsequent procalcitonin levels reflected closely the clin ical course of their infection. The serum concentration of procalciton in correlates well with the severity of Pseudomonas pseudomallei infec tion and is comparable with other acute-phase markers. However, this p rognostic indicator and marker of continuing disease activity is not s pecific to melioidosis and could be applied to other severe infections .