Procalcitonin as Point-of-Care Testing Modality in Children with Influenza-like Illness

A new study assessed the efficacy 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 was conducted at the pediatric emergency department of a tertiary hospital. Point-of-care testing for PCT was conducted on 185 children aged 3 months to under 18 years with ILI and fever lasting more than four days – seen during the 2020 flu season. For patients with PCT levels exceeding 0.5 ng/mL, a chest radiograph (CXR) was performed.

Among the children enrolled, 24.9% had a PCT value greater than 0.5 ng/mL. CXRs were ordered for all but one of these cases, and 31.1% were diagnosed with radiographic pneumonia, all with a PCT value exceeding 0.7 ng/mL. Of the 139 patients with a PCT value of 0.5 ng/mL or less, 98.6% were managed on an outpatient basis with symptomatic treatment. The remaining two cases underwent CXRs, both of which were unremarkable. Upon follow-up, none of these patients were diagnosed with radiographic pneumonia.

From the results, it was inferred that PCT is a valuable tool for point-of-care testing in cases of ILI with a fever lasting more than four days. It aids in determining the necessity of CXR to rule out radiographic pneumonia––thereby reducing unnecessary radiation exposure. If these findings are validated by further studies in the general pediatric population, the integration of point-of-care PCT testing, feasible in emergency departments, could enhance the management of children suspected of having pneumonia in pediatric clinical settings and minimize unwarranted radiation exposure.

Source: Hernández-Bou S, Trenchs V, Guirado C, Castrillón I, Luaces C. Indian Pediatrics. 2024 Jan 15;61(1):57-61.