Procalcitonin as a Diagnostic Marker in Patients with Infectious Diseases

Background: Procalcitonin levels have been shown to indicate severity of a disease, but there have been few reports about interpretation of procalcitonin levels between different diseases. This study was therefore carried out to investigate the usefulness of procalcitonin for clinical diagnosis, and for discriminating between bacterial and viral infection, between cystitis and pyelonephritis, and between acute upper respiratory inflammation and pneumonia.Methods: Among patients with the primary complaint of fever who were treated, either hospitalized or as out-patients, at Saitama Medical University Hospital during a 5-year period from August 1, 2012, to July 31, 2017, the potential subjects for this study were the 362 patients, consisting of 191 males and 171 females, with whom procalcitonin was measured. The subjects with whom comparative evaluation was carried out were the 205 with whom the final diagnoses were diseases, these being infectious diseases, malignancies, collagen diseases, and benign tumors with 176, 12, 11 and 6 patients, respectively. The remaining patients were excluded from the study, these consisting of 150 patients with whom the final diagnosis was merely symptoms such as headache, or was a condition not covered by internal medicine, such as traumas; and 7 patients whose diagnoses were unknown.Results: Procalcitonin levels in patients with infectious diseases were significantly higher (p < 0.05) than in patients with malignant tumors, collagen diseases, or benign tumors. Comparison between different diseases showed significant differences (p < 0.05) between pyelonephritis and cystitis, and between bacterial pneumonia and acute upper respiratory inflammation.Conclusions: Procalcitonin was significantly elevated in patients with bacterial infection. Significant differences in procalcitonin level were found between pyelonephritis and cystitis, and between bacterial pneumonia and acute upper respiratory inflammation, so procalcitonin is considered to be useful for discrimination between these.

Arthralgia in Egyptian children

Background Children presenting with joint pains are a very common occurrence in any general pediatric outpatient department. About 15% of general pediatric consultations are for myriad pains of the musculoskeletal system. Aim of the work To screen Egyptian children presenting to a tertiary center for different causes of arthralgia. Subjects and Methods This is a descriptive study that was conducted on 200 pediatric patients (86 males and 114 females) presenting with arthralgia at the Children’s hospital Ain shams University from August 2017 till April 2018. Patients with chronic illness, skeletal deformity, past history of acute rheumatic fever, and any patient with acute febrile illness were excluded. All patients were subjected to full medical history, examination, laboratory investigation as complete blood picture, erythrocyte sedimentation rate, c reactive protein, electrocardiography and echocardiography. Results Around 18% of patients with arthralgia were proved to have post streptococcal arthralgia, 35% had collagen diseases, 10% with malignant conditions. no identifiable cause could be found in 36% of the patients and two patients diagnosed as acute rheumatic fever. Conclusion Arthralgia is a common symptom in the pediatric age group. Although it is a benign condition, sometimes it accurs due to serious illness like malignancy or collagen diseases.