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Procalcitonin as a diagnostic indicator for systemic bacterial infections in patients with Stevens–Johnson syndrome/toxic epidermal necrolysis
Author(s) -
Wang Qian,
Tian XiaoBing,
Liu Wei,
Zhang LiXia
Publication year - 2018
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.14488
Subject(s) - procalcitonin , toxic epidermal necrolysis , medicine , gastroenterology , systemic inflammation , dermatology , immunology , sepsis , inflammation
Elevated serum procalcitonin ( PCT ) level has been reported to be a diagnostic index in systemic bacterial infections, but it can also increase in some non‐infectious inflammatory diseases. Stevens–Johnson syndrome ( SJS )/toxic epidermal necrolysis ( TEN ) is a rare immune‐mediated cutaneous mucosal reaction which is susceptible to bacterial infections and may have elevated PCT levels. The value of serum PCT has not been assessed in series of SJS / TEN patients. We aimed to investigate the PCT levels in SJS / TEN patients with systemic bacterial infections (systemic infected group), with skin surface bacterial infections (skin surface infected group) and without infections (non‐infected group), to assess whether PCT was a valuable indicator for systemic bacterial infections in SJS / TEN patients. The PCT and C‐reactive protein ( CRP ) levels of 42 inpatients with SJS / TEN were retrospectively analysis. The receiver–operator curve ( ROC ) was used to determine the diagnostic efficacy of PCT for systemic bacterial infections in SJS / TEN patients. The results demonstrated that PCT levels in the systemic infected group were significantly higher than those in the other two groups ( P < 0.05). There was no significant difference in CRP between the three groups. The cut‐off PCT level of 0.65 ng/mL calculated by ROC had optimal diagnostic efficacy, with sensitivity and specificity of 84.6% and 89.7%, respectively. PCT and severity‐of‐illness score for toxic epidermal necrolysis were positively correlated ( P < 0.05). In conclusion, PCT is a valuable index and superior to CRP in detecting systemic bacterial infections in SJS / TEN patients. The level of PCT can partially reflect the severity of the disease.