Role of C-Reactive Protein and Procalcitonin in Differentiation of Tuberculosis from Bacterial Community Acquired Pneumonia.
10.3904/kjim.2009.24.4.337
- Author:
Young Ae KANG
1
;
Sung Youn KWON
;
Ho IL YOON
;
Jae Ho LEE
;
Choon Taek LEE
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
C-reactive protein;
Pneumonia, community acquired;
Procalcitonin;
Tuberculosis
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
C-Reactive Protein/*analysis;
Calcitonin/*blood;
Community-Acquired Infections/blood/*diagnosis;
Diagnosis, Differential;
Female;
Humans;
Male;
Middle Aged;
Pneumonia, Bacterial/blood/*diagnosis;
Prospective Studies;
Protein Precursors/*blood;
Severity of Illness Index;
Tuberculosis, Pulmonary/blood/*diagnosis
- From:The Korean Journal of Internal Medicine
2009;24(4):337-342
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: We investigated the utility of serum C-reactive protein (CRP) and procalcitonin (PCT) for differentiating pulmonary tuberculosis (TB) from bacterial community-acquired pneumonia (CAP) in South Korea, a country with an intermediate TB burden. METHODS: We conducted a prospective study, enrolling 87 participants with suspected CAP in a community-based referral hospital. A clinical assessment was performed before treatment, and serum CRP and PCT were measured. The test results were compared to the final diagnoses. RESULTS: Of the 87 patients, 57 had bacterial CAP and 30 had pulmonary TB. The median CRP concentration was 14.58 mg/dL (range, 0.30 to 36.61) in patients with bacterial CAP and 5.27 mg/dL (range, 0.24 to 13.22) in those with pulmonary TB (p<0.001). The median PCT level was 0.514 ng/mL (range, 0.01 to 27.75) with bacterial CAP and 0.029 ng/mL (range, 0.01 to 0.87) with pulmonary TB (p<0.001). No difference was detected in the discriminative values of CRP and PCT (p=0.733). CONCLUSIONS: The concentrations of CRP and PCT differed significantly in patients with pulmonary TB and bacterial CAP. The high sensitivity and negative predictive value for differentiating pulmonary TB from bacterial CAP suggest a supplementary role of CRP and PCT in the diagnostic exclusion of pulmonary TB from bacterial CAP in areas with an intermediate prevalence of pulmonary TB.
