Determining the Role of Procalcitonin and C-reactive Protein in Diagnostic Tests for Respiratory Adenovirus Infections in Children

The purpose of this study is to determine whether procalcitonin testing can distinguish between bacterial and AdV infections when acute phase values are significantly high. Adenovirus (AdV) infections differ in type and severity. The most prevalent are infections of the airways. The investigations were carried out in the pediatric department of a local hospital as part of routine medical care. 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 g/L. AdV was determined by polymerase-chain-reaction. The PCT value in Group 1 is 0.21 ± 0.12 g/L, median 0.2, and 1.56 ± 1.07 g/L, median 1.3 (p = 0.0001) in Group 2. At a cut-off value of <0.5 g/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 g/L. 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 g/l. The inflammatory mechanism can be initiated, for example, by severe tissue trauma, burns, extensive surgery, persistent perfusion defect, cardiogenic shock and also by severe AdV infections via the release of cytokines.