A child with febrile neutropenia is at risk for bacteremia. Reitman et al used serial serum procalcitonin concentrations to identify patients at high risk for bacteremia. The authors are from Children’s Hospital Los Angeles.
Patient selection: pediatric patient with febrile neutropenia (fever > 38°C AND absolute neutrophil count < 500 per microliter).
Method for serum procalcitonin: KRYPTOR (Brahms International, Thermo Fisher)
Protocol:
(1) serum procalcitonin concentration at time of admission
(2) serum procalcitonin concentration at 24 hours after admission
Finding
Interpretation
both < 0.2 ng/mL
100% negative for bacteremia
at least one > 0.5 ng/mL
sensitivity 78%, specificity 76%, negative predictive value 93%
second value > 0.4 ng/mL
sensitivity 89%, specificity 68%, negative predictive value 96%
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