Usefulness of procalcitonin rapid test for the diagnosis of acute pyelonephritis in children in the emergency department

Abstract

Urinary tract infection (UTI) is a common problem in children. The aim of this study was to determine the usefulness of the procalcitonin (PCT) rapid test in the diagnosis of renal involvement in children with urinary tract infection. Through a case series study, PCT and C-reactive protein rapid tests were measured in children with proven UTI at the Tehran Children's Medical Center, Iran. One-hundred patients aged 1 month-14 years old (19 boys and 81 girls) with documented UTI were enrolled in the study. Of 100 children, 62 patients (62%) had renal involvement on the basis of abnormal Tc-dimercaptosuccinic acid scintigraphy and 38 patients (38%) had infection restricted to the lower urinary tract. There were no differences related to age or gender among the groups. The sensitivity and specificity of PCT were 77% and 89%, respectively, in prediction of renal involvement, whereas C-reactive protein had a sensitivity of 80% and a specificity of 65%. We concluded that a rapid determination of PCT concentration could be useful for the management of children with febrile UTI in the emergency room.