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The role of Procalcitonin in management of pleural infections

Syed Mohannad, Yusuf Vali, Muhammad Naeem, George Tsaknis, Raja Reddy
European Respiratory Journal 2019 54: PA3837; DOI: 10.1183/13993003.congress-2019.PA3837
Syed Mohannad
1Kettering General Hospital, kettering, United Kingdom
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  • For correspondence: mohammadsyed@live.com
Yusuf Vali
1Kettering General Hospital, kettering, United Kingdom
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Muhammad Naeem
1Kettering General Hospital, kettering, United Kingdom
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George Tsaknis
1Kettering General Hospital, kettering, United Kingdom
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Raja Reddy
1Kettering General Hospital, kettering, United Kingdom
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Abstract

Introduction: Procalcitonin (PCT) is a highly specific marker of systemic bacterial infection, however its role in guiding the management of pleural infection has not been explored. We investigated its role in the management of this condition.

Methods: Patients with a presentation consistent with pleural infection with either pleural fluid pH<7.2, positive gram stain or bacterial culture or frank pus in the pleural cavity were included. They were managed with chest tube drainage and targeted pleural aspirations as needed. Inflammatory markers including PCT were measured regularly and no change to management was made if PCT levels were improving (regardless of CRP). Patients were referred for surgery if there was a lack of response to treatment. Appropriate antibiotics were given intravenously for one week followed by oral for at least 2 weeks until CRP <50.

Data were collected prospectively on all patients. Patients with an expected survival of <3 months from co-morbidities and those with iatrogenic infections were excluded.

Results: Between December 16 and March 18, 33 patients met our inclusion criteria. PCT levels dropped and sepsis resolved in all patients. Outcomes are listed in Table 1.

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Conclusion: PCT appears to be a more useful marker of treatment response for pleural infection. Pleural inflammation may be contributing to fever and elevated CRP leading to unnecessary surgical intervention in some patients.

  • Pneumonia
  • Pleura
  • Bacteria

Footnotes

Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3837.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2019
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The role of Procalcitonin in management of pleural infections
Syed Mohannad, Yusuf Vali, Muhammad Naeem, George Tsaknis, Raja Reddy
European Respiratory Journal Sep 2019, 54 (suppl 63) PA3837; DOI: 10.1183/13993003.congress-2019.PA3837

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The role of Procalcitonin in management of pleural infections
Syed Mohannad, Yusuf Vali, Muhammad Naeem, George Tsaknis, Raja Reddy
European Respiratory Journal Sep 2019, 54 (suppl 63) PA3837; DOI: 10.1183/13993003.congress-2019.PA3837
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