Serum C-reactive protein and procalcitonin values in acute Q fever, scrub typhus, and murine typhus

BMC Infectious Diseases

Yen-Hsu Chen¹  Yu-Ying Wu²  Chia-Ta Tsai³  I-Fan Lin³  Chung-Hsu Lai³  Jiun-Nong Lin⁴ 

[1] Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital;Department of Neurosurgery, E-Da Hospital, I-Shou University;Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University;School of Medicine, College of Medicine, I-Shou University;

关键词: C-reactive protein;    Procalcitonin;    Doxycycline;    Murine typhus;    Q fever;    Scrub typhus;   

DOI  :  10.1186/s12879-020-05058-8

来源: DOAJ

【 摘 要 】

Abstract Background Although C-reactive protein (CRP) and procalcitonin (PCT) are widely used inflammatory markers for infectious diseases, their role and potential application for rickettsioses were rarely studied. Methods A retrospective chart review and serological study were conducted in patients with rickettsioses. The clinical presentations, characteristics, laboratory data, and treatment responses were recorded and their associations with CRP and PCT values were analyzed. Results A total of 189 cases of rickettsioses, including 115 cases of acute Q fever (60.8%), 55 cases of scrub typhus (29.1%), and 19 cases of murine typhus (10.1%) were investigated. Both CRP and PCT values increased in the acute phase and declined in the convalescent phase. In the acute phase, mean CRP and PCT values were 78.2 ± 63.7 mg/L and 1.05 ± 1.40 ng/mL, respectively. Percentages of patients falling under different cut-off values of CRP and PCT were calculated systematically. Only 10.8% of CRP was > 150 mg/L and 14.2% of PCT was > 2.0 ng/mL. Patients with delayed responses to doxycycline treatment (> 3 days from treatment to defervescence) had significantly higher CRP values (102.7 ± 77.1 vs. 72.2 ± 58.2 mg/L, p = 0.041) and more PCT > 1.0 ng/ml (48.4% vs. 26.0%, p = 0.019) in the acute phase; higher CRP values (19.1 ± 37.4 vs. 3.6 ± 13.1 mg/L, p = 0.049) and more PCT > 0.5 ng/ml (19.2% vs. 1.4%, p = 0.005) in the convalescent phase. Correlation analysis was conducted for patients with acute Q fever. CRP and PCT values were positively correlated to each other, and both markers also had a positive correlation with serum aspartate transaminase values. Both CRP and PCT values and white blood cell counts were positively correlated to the days needed from doxycycline treatment to defervescence. Conclusion CRP and PCT values might be useful in clinical investigations for patients with suspected rickettsioses and in predicting the response to doxycycline treatment for rickettsioses.

【 授权许可】

Unknown