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  • Title: Procalcitonin and neopterin levels do not accurately distinguish bacterial from viral infections in ill-returned travellers with fever.
    Author: te Witt R, Hassing RJ, Petit PP, van Belkum A, van Genderen PJ.
    Journal: Trans R Soc Trop Med Hyg; 2012 Apr; 106(4):264-6. PubMed ID: 22357400.
    Abstract:
    The diagnostic performance of procalcitonin and neopterin as markers for bacterial and viral causes of fever was evaluated in a cohort of 69 febrile travellers with known etiological agents. Our aim was to establish a decision rule to minimize empirical antibiotic treatment. Compared with C-reactive protein (CRP) and leukocyte (differential) counts, procalcitonin and neopterin had a disappointing diagnostic accuracy. Refraining from antibiotics in case of combined presence of lymphocytosis and/or CRP ≤10 mg/l would result in an 85% reduction in unwanted antibiotic treatment in patients with viral disease but in adequate antibiotic coverage of all patients with bacterial disease.
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