Pro's and Con's of Procalcitonin

Pro's and Con's of Procalcitonin

Procalcitonin was reviewed on Taming the SRU in the context of other biomarkers (ESR, CRP) last year with a grand rounds discussion of its utility in the setting of a febrile 7 week old. As procalcitonin has continued to gain traction in the world of pediatric EM – receiving evaluation as part of proposed protocols for management of febrile infants (1) and for its utility as an aid to diagnosis of Serious Bacterial Infection (2,3) – we turned our attention this year to procalcitonin’s use in adults. Procalcitonin testing has been studied and available for decades (as St. Emlyn’s noted in an update earlier this year), but has not really established itself in widespread use in adults (as EMDocs noted in a sepsis update in 2014). In this blog post, we take the approach of going back to what is known (and is NOT known) about the biochemical basics of this molecule to give context to the sometimes confusing smorgasbord of proposed applications for procalcitonin testing that exists in the literature.

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Grand Rounds Recap 10.5.2016

Grand Rounds Recap 10.5.2016

This week we had a Grand Rounds jam packed with clinical knowledge. When was the last time you considered the differential diagnosis of an elevated troponin? It's not just ACS! Read on to learn more about thyroid storm, refractory Vfib and Vtach, lithium toxicity, inflammatory markers, and more. As well as a special clinical soapbox about how Ohio became the epicenter of the nation's heroin epidemic.

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ESR, CRP, & Procalcitonin: Acute Inflammatory Markers in the ED

ESR, CRP, & Procalcitonin: Acute Inflammatory Markers in the ED

Working in the ED one day you seem to hit a run of patients in whom consultants have asked you to order an ESR, CRP.  First, podiatry asked for them for a patient with 1st metatarsal osteomyelitis.  Spine surgery wanted the same for a patient with diskitis. And, ortho wanted them for a possible septic.  You think to yourself, “what am I or my consultant going to do with these test results?” “What are these inflammatory markers anyhow?” And, “what patient’s should I be ordering them in.”

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