The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case Report
Peiyi Luo,1,2,* Yanqiong Long,1,* Liang Ma,2 Ye Tao,1 Shenju Gou1 1Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, People’s Republic of China&...
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Dove Medical Press
2022-09-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/the-sustained-and-marked-elevation-of-serum-procalcitonin-in-a-hemodia-peer-reviewed-fulltext-article-IDR |
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| author | Luo P Long Y Ma L Tao Y Gou S |
| author_facet | Luo P Long Y Ma L Tao Y Gou S |
| author_sort | Luo P |
| collection | DOAJ |
| description | Peiyi Luo,1,2,* Yanqiong Long,1,* Liang Ma,2 Ye Tao,1 Shenju Gou1 1Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ye Tao; Shenju Gou, Department of Nephrology, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China, Tel/Fax +86-28-85423341, Email yehtao11@qq.com; goushenju@163.comBackground: The elevation of serum procalcitonin (PCT) has been considered as a marker of systemic bacterial infection and sepsis. However, the marked elevation of PCT in non-sepsis conditions was rare. Here, we report a rare case of sustained markedly elevation of serum PCT in a dialysis patient with tuberculosis, but without the evidence of sepsis.Case Presentation: A 25-year-old man on maintenance hemodialysis was admitted to the hospital for kidney transplantation. On admission, physical examination revealed multiple lymph nodes were palpable on both sides of the neck which was later confirmed as tuberculosis with biopsy pathology. On the 3rd day after admission, the patient suffered from fever with a temperature of 38.8°C. The white blood cells 12.35 × 109/L and the PCT level was 5.73 ng/mL. Lately the PCT increased to 63.10 ng/mL, and the level of C-reactive protein was 186.00 mg/L. After the antibiotics upgraded from cefmetazole to meropenem, and vancomycin was added, the body temperature dropped to the normal range on the 17th day and remained normal thereafter. The PCT level declined gradually to 4.18 ng/mL on the 21st day and an antituberculosis regimen was started. After that, the PCT levels fluctuated between 2.9 ng/mL and 94.9 ng/mL without any manifestation of sepsis. The markedly elevation of serum PCT level persisted despite normal C-reactive protein level and leukocyte counts.Conclusion: Persistently elevated serum PCT level might occur in conditions without evidence of sepsis. Taking consideration of multiple inflammatory factors to determine infection when the markedly elevated PCT level was not correlated with the clinical manifestations.Keywords: procalcitonin, bacterial infection, dialysis, tuberculosis |
| first_indexed | 2024-04-11T21:26:11Z |
| format | Article |
| id | doaj.art-d6d0164efbc84e3d91e58ef963e1b629 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-11T21:26:11Z |
| publishDate | 2022-09-01 |
| publisher | Dove Medical Press |
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| series | Infection and Drug Resistance |
| spelling | doaj.art-d6d0164efbc84e3d91e58ef963e1b6292022-12-22T04:02:24ZengDove Medical PressInfection and Drug Resistance1178-69732022-09-01Volume 155161516677897The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case ReportLuo PLong YMa LTao YGou SPeiyi Luo,1,2,* Yanqiong Long,1,* Liang Ma,2 Ye Tao,1 Shenju Gou1 1Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ye Tao; Shenju Gou, Department of Nephrology, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China, Tel/Fax +86-28-85423341, Email yehtao11@qq.com; goushenju@163.comBackground: The elevation of serum procalcitonin (PCT) has been considered as a marker of systemic bacterial infection and sepsis. However, the marked elevation of PCT in non-sepsis conditions was rare. Here, we report a rare case of sustained markedly elevation of serum PCT in a dialysis patient with tuberculosis, but without the evidence of sepsis.Case Presentation: A 25-year-old man on maintenance hemodialysis was admitted to the hospital for kidney transplantation. On admission, physical examination revealed multiple lymph nodes were palpable on both sides of the neck which was later confirmed as tuberculosis with biopsy pathology. On the 3rd day after admission, the patient suffered from fever with a temperature of 38.8°C. The white blood cells 12.35 × 109/L and the PCT level was 5.73 ng/mL. Lately the PCT increased to 63.10 ng/mL, and the level of C-reactive protein was 186.00 mg/L. After the antibiotics upgraded from cefmetazole to meropenem, and vancomycin was added, the body temperature dropped to the normal range on the 17th day and remained normal thereafter. The PCT level declined gradually to 4.18 ng/mL on the 21st day and an antituberculosis regimen was started. After that, the PCT levels fluctuated between 2.9 ng/mL and 94.9 ng/mL without any manifestation of sepsis. The markedly elevation of serum PCT level persisted despite normal C-reactive protein level and leukocyte counts.Conclusion: Persistently elevated serum PCT level might occur in conditions without evidence of sepsis. Taking consideration of multiple inflammatory factors to determine infection when the markedly elevated PCT level was not correlated with the clinical manifestations.Keywords: procalcitonin, bacterial infection, dialysis, tuberculosishttps://www.dovepress.com/the-sustained-and-marked-elevation-of-serum-procalcitonin-in-a-hemodia-peer-reviewed-fulltext-article-IDRprocalcitoninbacterial infectiondialysistuberculosis |
| spellingShingle | Luo P Long Y Ma L Tao Y Gou S The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case Report Infection and Drug Resistance procalcitonin bacterial infection dialysis tuberculosis |
| title | The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case Report |
| title_full | The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case Report |
| title_fullStr | The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case Report |
| title_full_unstemmed | The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case Report |
| title_short | The Sustained and Marked Elevation of Serum Procalcitonin in a Hemodialysis Patient with Tuberculous Lymphadenitis, but Without the Evidence of Sepsis: A Case Report |
| title_sort | sustained and marked elevation of serum procalcitonin in a hemodialysis patient with tuberculous lymphadenitis but without the evidence of sepsis a case report |
| topic | procalcitonin bacterial infection dialysis tuberculosis |
| url | https://www.dovepress.com/the-sustained-and-marked-elevation-of-serum-procalcitonin-in-a-hemodia-peer-reviewed-fulltext-article-IDR |
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