PCT as a Prognostic Marker in Cardiac Patients with Neutropenic Sepsis: Two Case Reports

Abstract

Procalcitonin (PCT) is an innovative and highly specific marker for diagnosis of clinically relevant bacterial infection and sepsis. PCT supports early diagnosis and Clinical decision making. A retrospective study of two classical cases of neutropenic sepsis with elevated PCT levels in cardiac ICU was done. PCT was analyzed using Elecsys Brahms PCT kit. Serum PCT levels <0.5 ng/ml and ANC <1,000/mm(3) was taken as cutoff. The first patient had initial high levels of PCT 100 ng/ml, TLC 13,600/mm(3) and ANC 12,250/mm(3). It was followed by drop with subsequent rise in PCT levels and drop in TLC 1,000/mm(3) and ANC 70/mm(3). The second patient had normal PCT 0.116 ng/ml, TLC 5,600/mm(3) and ANC 4,420/mm(3) levels followed with sharp increase in all the values with subsequent drop in TLC 2,000/mm(3) and ANC 880 cells/mm(3). Both the patients died of neutropenic sepsis with multiorgan failure. The case reports showed the correlation of PCT with TLC and ANC levels in predicting the mortality of patients with neutropenic sepsis in cardiac ICU.