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Procalcitonin as Point-of-Care Testing Modality for the Diagnosis of Pneumonia in Children With Influenza-like Illness

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Abstract

Objective

To evaluate the usefulness of procalcitonin (PCT) as a point-of-care testing to screen for radiographic pneumonia among children with influenza-like illness (ILI) and prolonged fever.

Methods

A prospective cohort study conducted at the pediatric emergency department of a tertiary hospital. Point-of-care testing for PCT was determined for 185 children aged 3 months to < 18 years with ILI and fever lasting > 4 days seen during the flu season in 2020. A chest radiograph (CXR) was performed for patients with PCT > 0.5 ng/mL.

Results

PCT value was > 0.5 ng/mL in 46 (24.9%) patients; a CXR was ordered in all cases except one and 14 (31.1%) of them had radiographic pneumonia (all had a PCT value > 0.7 ng/mL). Among the 139 (75.1%) patients with a PCT value ≤ 0.5 ng/mL, 137 (98.6%) were managed in the outpatient with symptomatic treatment; the remaining two cases warranted a CXR which was unremarkable in both. At evolution, no radiographic pneumonia was diagnosted in any of them.

Conclusion

PCT is a useful tool for point-of-care testing in patients with ILI and fever > 4 days to guide the indication for CXR to rule out radiographic pneumonia and helps in avoiding unnecessary radiation exposure.

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Funding

Funding: This study was partly supported by Brahms Diagnostica, GmbH, Berlin, Germany, who provided the Thermo Scientific™ B·R·A·H·M·S PCT™ direct test instrument and kits for the study. The study sponsor played no role in the study design, data collection, data analysis, or interpretation of results; writing of the report, or in the decision to submit the paper for publication.

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Authors and Affiliations

  1. Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain

    Susanna Hernández-Bou,  Victoria Trenchs, Cristina Guirado, Ignacio Castrillón & Carles Luaces

Authors
  1. Susanna Hernández-Bou
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  2. Victoria Trenchs
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  3. Cristina Guirado
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  4. Ignacio Castrillón
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  5. Carles Luaces
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Contributions

Contributors: SHB: Conceptualized and designed the study, analyzed, and interpreted data, and drafted the initial manuscript; VT: Conceptualized and designed the study, was involved in obtaining ethics approval, analyzed, and interpreted data and revised the manuscript; CG, IC: Conceptualized the study, enrolled patients and did data collection; CL: Conceptualized the study and provided critical review of the original and subsequent manuscript drafts. All authors approved the final manuscript as submitted.

Corresponding author

Correspondence to Victoria Trenchs.

Ethics declarations

Ethics Clearance: The Sant Joan de Déu Research Foundation Ethics Committee; PIC-166-18, dated Jan 24, 2019.

Competing interests: None stated.

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Hernández-Bou, S., Trenchs, V., Guirado, C. et al. Procalcitonin as Point-of-Care Testing Modality for the Diagnosis of Pneumonia in Children With Influenza-like Illness. Indian Pediatr 61, 57–61 (2024). https://doi.org/10.1007/s13312-024-3089-0

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  • DOI: https://doi.org/10.1007/s13312-024-3089-0

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