tailieunhanh - Role of C-Reactive Protein and Procalcitonin in Differentiation of Tuberculosis from Bacterial Community Acquired Pneumonia

Community-acquired pneumonia (CAP) is a major cause of hospital admission and the most important infectious cause of death [1]. A rapid diagnosis and appropriate antibiotic treatment are essential to reduce the morbidity and mortality from CAP. In countries with a high tuberculosis (TB) burden, Mycobacterium tuberculosis is a frequent cause of CAP [2-4], and the differential diagnosis of TB from common bacterial pneumonia is difficult. The varying clinical and radiographic presentation of CAP and TB according to patient age and comorbidity and the low sensitivity of acid-fast bacillus microscopy make it even more difficult to distinguish TB from common bacterial pneumonia [5-7]. Therefore, an adjunct diagnostic method that can determine whether CAP is caused. | ORIGINAL ARTICLE DOI Role of C-Reactive Protein and Procalcitonin in Differentiation of Tuberculosis from Bacterial Community Acquired Pneumonia Young Ae Kang1 Sung-Youn Kwon2 Ho IL Yoon2 Jae Ho Lee2 and Choon-Taek Lee2 Department of Internal Medicine Yonsei University College of Medicine Seoul 2Department of Internal Medicine Respiratory Center Seoul National University Bundang Hospital Seongnam Korea Background Aims We investigated the utility of serum C-reactive protein CRP and procalcitonin PCT for differentiating pulmonary tuberculosis TB from bacterial community-acquired pneumonia CAP in South Korea a country with an intermediate TB burden. Methods We conducted a prospective study enrolling 87 participants with suspected CAP in a community-based referral hospital. A clinical assessment was performed before treatment and serum CRP and PCT were measured. The test results were compared to the final diagnoses. Results Of the 87 patients 57 had bacterial CAP and 30 had pulmonary TB. The median CRP concentration was mg dL range to in patients with bacterial CAP and mg dL range to in those with pulmonary TB p . The median PCT level was ng mL range to with bacterial CAP and ng mL range to with pulmonary TB p . No difference was detected in the discriminative values of CRP and PCT 0 . Conclusions The concentrations of CRP and PCT differed significantly in patients with pulmonary TB and bacterial CAP. The high sensitivity and negative predictive value for differentiating pulmonary TB from bacterial CAP suggest a supplementary role of CRP and PCT in the diagnostic exclusion of pulmonary TB from bacterial CAP in areas with an intermediate prevalence of pulmonary TB. Korean J Intern Med 2009 24 337-342 Keywords C-reactive protein Pneumonia community acquired Procalcitonin Tuberculosis INTRODUCTION Community-acquired pneumonia CAP is a major cause of hospital .

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