Procalcitonin as Point-of-Care Testing Modality for Diagnosing Pneumonia in Children With ILI

A new study aimed to assess the effectiveness of procalcitonin (PCT) as a point-of-care test for screening radiographic pneumonia in children with influenza-like illness (ILI) and prolonged fever. 

This prospective cohort study included 185 children between 3 months and below 18 years of age, with ILI and fever lasting > 4 days––seen at a pediatric emergency department during the 2020 flu season. Point-of-care PCT testing was conducted, and a chest radiograph (CXR) was performed for patients with PCT > 0.5 ng/mL.

It was found that 24.9% of patients had PCT values > 0.5 ng/mL – leading to CXR orders for all but one case. Among those with elevated PCT, 31.1% had radiographic pneumonia – all with PCT > 0.7 ng/mL. Contrastingly, 75.1% of patients with PCT ≤ 0.5 ng/mL (98.6% of this group) were managed as outpatients with symptomatic treatment. Only two cases in this group required CXR, both unremarkable, and no radiographic pneumonia was diagnosed at follow-up.

From the results, it was inferred that procalcitonin is a valuable biomarker for guiding the decision to perform a chest radiograph in children with ILI and prolonged fever – potentially reducing unnecessary radiation exposure. PCT is a valuable point-of-care tool for guiding CXR indications in children with ILI and fever > 4 days, aiding in avoiding unnecessary radiation exposure. Introducing point-of-care PCT testing in pediatric emergency departments could enhance the management of suspected pneumonia cases and provide a quick and efficient approach. 

Source:Hernández-Bou S, Trenchs V, Guirado C, Castrillón I, Luaces C. Indian Pediatrics. 2024 Jan.