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The Significance of Procalcitonin and C-Reactive Protein in Diagnostic Tests for Respiratory Adenovirus Infections in Children

DOI: 10.4236/oalib.1101717, PP. 1-8

Subject Areas: Virology

Keywords: Adenovirus, Respiratory Infection, Procalcitonin, C-Reactive Protein, Antibiotics, Children

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Background: This study aims to answer the question if procalcitonin tests allow distinguishing bacterial from AdV infections in cases in which acute phase values are significantly elevated. Methods: 40 patients of infant and toddler age were divided into two patient groups (n = 23) and (n = 17) for comparison based on PCT 0.5 μg/L. AdV was determined by polymerase-chain-reaction. Results: The PCT value in Group 1 is 0.21 ± 0.12 μg/L, median 0.2, and 1.56 ± 1.07 μg/L, median 1.3 (p = 0.0001) in Group 2. At a cut-off value of <0.5 μg/L, C-reactive protein, leucocytes, age, fever temperature, and the duration of fever did not differ significantly. This conclusion also applies to a PCT value to <0.9 μg/L. Conclusions: In AdV infections, CRP values of >40 mg/L are observed in more than 80% of patients. A clinically relevant conclusion of our findings is that independent of CRP levels antibiotic therapy is not indicated up to PCT levels of 0.5 μg/l.

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Kunze, W. , Klemm, T. and Streidl, J. (2015). The Significance of Procalcitonin and C-Reactive Protein in Diagnostic Tests for Respiratory Adenovirus Infections in Children. Open Access Library Journal, 2, e1717. doi:


[1]  Padiatrische Infektiologie (Hrsg.) (2013) DGPI Handbuch Infektionen bei Kindern und Jugendlichen. 6. vollst. überarb. Aufl., G. Thieme Verlag, Stuttgart, New York, 142-146.
[2]  Lynch, J.P., Fishbein, M. and Echavarria, M. (2011) Adenovirus. Seminars in Respiratory and Critical Care Medicine, 32, 494-511.
[3]  Irwin, A.D. and Carrol, E.D. (2011) Procalcitonin. Archives of Disease in Childhood—Education & Practice Edition, 96, 228-233.
[4]  Meisner, M. (2010) ProcalcitoninBiochemie und klinische Diagnostik. 1. Auflage-Bremen: UNI-MED.
[5]  Heim, A., Ebnet, C., Harste, G., et al. (2003) Rapid and Quantitative Detection of Human Adenovirus DNA by Real-Time PCR. Journal of Medical Virology, 70, 228-239.
[6]  Cheng, C.C., Huang, L.M., Kao, C.L., et al. (2008) Molecular and Clinical Characteristics of Adenoviral Infections in Taiwanese Children in 2004-2005. European Journal of Pediatrics, 167, 633-640.
[7]  Chuang, Y.Y., Chiu, C.H., Wong, K.S., et al. (2003) Severe Adenovirus Infection in Children. Journal of Microbiology, Immunology and Infection, 36, 37-40.
[8]  Chen, H.L., Chiou, S.S., Hsioao, H.P., et al. (2004) Respiratory Adenoviral Infections in Children: A Study of Hospitalized Cases in Southern Taiwan in 2001-2002. Journal of Tropical Pediatrics, 50, 279-284.
[9]  Dominguez, O., Rojo, P., de las Heras, S., et al. (2005) Clinical Presentation and Characteristics of Pharyngeal Adenovirus Infections. The Pediatric Infectious Disease Journal, 24, 733-734.
[10]  Tabain, I., Ljubin-Sternak, S., Cepin-Bogovic, L., et al. (2012) Adenovirus Respiratory Infections in Hospitalized Children: Clinical Findings in Relation to Species and Serotypes. The Pediatric Infectious Disease Journal, 31, 680- 684.
[11]  Lin, C.H., Huang, Y.C., Chiu, C.H., Huang, C.G., Tsao, K.C. and Lin, T.Y. (2007) A Cluster of Adenovirus Serotype 3 Infections in Children in Northern Taiwan: Clinical Features and Laboratory Findings. Journal of Microbiology, Immunology and Infection, 40, 302-309.
[12]  Kunze, W., Beier, D. and Groger, K. (2010) Adenovirus Respiratory Infections in Children. Do They Mimic Bacterial Infections? WebMedCentral PAEDIATRICS, 1, Article ID: WMC001098.
[13]  Farng, K.T., Wu, K.G., Lee, Y.S., Lin, Y.H. and Hwang, B.T. (2002) Comparison of Clinical Characteristics of Adenovirus and Non-Adenovirus Pneumonia in Children. Journal of Microbiology, Immunology and Infection, 35, 37-41.
[14]  Kawasaki, Y., Hosoya, M., Katayose, M. and Suzuki, H. (2002) Correlation between Serum Interleukin 6 and C-Reactive Protein Concentrations in Patients with Adenoviral Respiratory Infection. The Pediatric Infectious Disease Journal, 21, 370-374.
[15]  Oda, K. and Yamamoto, Y. (2008) Serum Interferon-γ, Interleukin-4, and Interleukin-6 in Infants with Adenovirus and Respiratory Syncytial Virus Infection. Pediatrics International, 50, 92-94.
[16]  Appenzeller, C., Amman, R.A., Duppenthaler, A., Gorgievski-Hrisoho, M. and Aebi, C. (2002) Serum C-Reactive Protein in Children with Adenovirus Infection. Swiss Medical Weekly, 132, 345-350.
[17]  Rocholl, C., Gerber, K., Daly, J., Pavia, A.T. and Byington, C.L. (2004) Adenoviral Infections in Children: The Impact of Rapid Diagnosis. Pediatrics, 113, e51-e56.
[18]  Van Lierde, S., Corbeel, L. and Eggermont, E. (1989) Clinical and Laboratory Findings in Children with Adenovirus Infections. European Journal of Pediatrics, 148, 423-425.
[19]  Korppi, M. and Kroger, L. (1993) C-Reactive Protein in Viral and Bacterial Respiratory Infection in Children. Scandinavian Journal of Infectious Diseases, 25, 207-213.
[20]  Korppi, M., Leinonen, M., Makela, P.H. and Launiala, K. (1991) Mixed Infection Is Common in Children with Respiratory Adenovirus Infection. Acta Paediatrica, 80, 413-417.
[21]  Elenius, V., Peltola, V., Ruuskanen, O., Yliharsila, M. and Waris, M. (2011) Plasma Procalcitonin Levels in Children with Adenovirus Infection. Archives of Disease in Childhood, 97, 582-583.
[22]  Galetto-Lacour, A., Zamora, S.A. and Gervaix, S.A. (2003) Bedside Procalcitonin and C-Reactive Protein Tests in Children with Fever without Localizing Signs of Infection Seen in a Referral Center. Pediatrics, 112, 1054-1060.
[23]  Hatherill, M., Tibby, S.M., Sykes, K., Turner, C. and Murdoch, I.A. (1999) Diagnostic Markers of Infection: Comparison of Procalcitonin with C-Reactive Protein and Leucocyte Count. Archives of Disease in Childhood, 81, 417-421.
[24]  Fernández Lopez, A., Luaces Cubells, C., García García, J.J. and Fernández Pou, J., Spanish Society of Pediatric Emergencies (2003) Procalcitonin in Pediatric Emergency Departments for the Early Diagnosis of Invasive Bacterial Infections in Febrile Infants: Results of a Multicenter Study and Utility of a Rapid Qualitative Test for This Marker. The Pediatric Infectious Disease Journal, 22, 895-904.
[25]  Limper, M., Smit, P.M., Bongers, K.M., van Zanten, A.P., Smits, P.H.M., Brandjes, D.P.M., et al. (2010) Procalcitonin in Children with Suspected Novel Influenza A (H1N1) Infection. Journal of Infection, 61, 351-353.
[26]  Toikka, P., Irjala, K., Juvén, T., Virkki, R., Mertsola, J., Leinonen, M. and Ruuskanen, O. (2000) Serum Procalcitonin, C-Reactive Protein and Interleukin-6 for Distinguishing Bacterial and Viral Pneumonia in Children. The Pediatric Infectious Disease Journal, 19, 598-602.
[27]  Matesanz, J.L., Fernández, E., Fernández, J.M. and Viejo, G. (2003) Plasma Procalcitonin and C-Reactive Protein Concentrations in Pediatric Patients with Epstein-Barr Virus Infection. Clinical Chemistry, 49, 2103-2104.
[28]  Resch, B., Gusenleitner, W. and Müller, W. (2003) Procalcitonin, Interleukin-6, C-Reactive Protein and Leukocyte Counts in Infants with Bronchiolitis. The Pediatric Infectious Disease Journal, 22, 475-476.
[29]  Piacentini, E., Sánchez, B., Arauzo, V., Calbo, E., Cuchi, E. and Nava, J.M. (2011) Procalcitonin Levels Are Lower in Intensive Care Unit with H1N1 Influenza A Virus Pneumonia than in Those with Community-Acquired Bacterial Pneumonia: A Pilot Study. Journal of Critical Care, 26, 201-205.
[30]  Ingram, P.R., Inglis, T., Moxon, D. and Speers, D. (2010) Procalcitonin and C-Reactive Protein in Severe 2009 H1N1 Influenza Infection. Intensive Care Medicine, 36, 528-532.
[31]  Cuquemelle, E., Soulis, F., Villers, D., Roche-Campo, F., Ara Somohano, C., Fartoukh, M., et al., A/H1N1 REVA-SRLF Study Group (2011) Can Procalcitonin Help Identify Associated Bacterial Infection in Patients with Severe Influenza Pneumonia? A Multicenter Study. Intensive Care Medicine, 37, 796-800.
[32]  Albrich, W.C., Dusemund, F., Bocher, B., Meyer, S., Thomann, R., Kühn, F., et al. (2012) Effectiveness and Safety of Procalcitonin-Guided Antibiotic Therapy in Lower Respiratory Tract Infections in “Real Life”: An International Multicenter Poststudy Survey (ProREAL). Archives of Internal Medicine, 172, 715-722.
[33]  Burkhardt, O., Ewing, S., Haagen, U., Giersdorf, S., Hartmann, O., Wegscheider, K., et al. (2010) Procalcitonin-Guidance and Reduction of Antibiotic Use in Acute Respiratory Tract Infection. European Respiratory Journal, 36, 601-607.
[34]  Schützle, H., Forster, J., Superti-Furga, A. and Berner, R. (2009) Is Serum Procalcitonin a Reliable Diagnostic Marker in Children with Acute Respiratory Tract Infections? A Retrospective Analysis. European Journal of Pediatrics, 168, 1117-1124.
[35]  Baer, G., Baumann, P., Buettcher, M., Heininger, U., Berthet, G., Schafer, J., et al. (2013) Procalcitonin Guidance to Reduce Antibiotic Treatment of Lower Respiratory Tract Infection in Children and Adolescents (ProPAED): A Randomized Controlled Trial. PLoS ONE, 8, e68419.
[36]  Linscheid, P., Seboek, D., Schaer, D.J., Zulewski, H., Keller, U. and Müller, B. (2004) Expression and Secretion of Procalcitonin and Calcitonin Gene-Related Peptide by Adherent Monocytes and by Macrophage-Activated Adipocytes. Critical Care Medicine, 32, 1715-1721.
[37]  Higginbotham, J.N., Seth, P., Blaese, R.M. and Ramsey, W.J. (2002) The Release of Inflammatory Cytokines from Human Peripheral Blood Mononuclear Cells in Vitro Following Exposure to Adenovirus Variants and Capsid. Human Gene Therapy, 13, 129-141.
[38]  Diaz, P.V., Calhoun, W.J., Hinton, K.L., Avendano, L.F., Gaggero, A., Simon, V., et al. (1999) Differential Effects of Respiratory Syncytial Virus and Adenovirus on Mononuclear Cell Cytokine Responses. American Journal of Respiratory and Critical Care Medicine, 160, 1157-1164.


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