• Sümeyye Selim Kara, Ayhan Akbulut, Ayşe Sağmak Tartar, Hatice Handan Akbulut, Kutbeddin Demirdağ, and Azize Beştaş.
• MD. Attending Physician, Department of Infectious Diseases and Clinical Microbiology, Fırat Üniversitesi Tıp Fakültesi, Elazig, Turkey.
• Sao Paulo Med J. 2019 Jan 1; 137 (4): 349355349-355.

BackgroundMaking the differential diagnosis between central fever and infectious fever is critically important among intracerebral hemorrhage patients followed up in intensive care units (ICUs). Serum procalcitonin (PCT) has been found to be a promising biomarker for the initial diagnosis of infection, even before culturing results.ObjectivesTo investigate the relationship between PCT and both fever etiologies and C-reactive protein (CRP) levels among critically ill patients with suspected intracerebral hemorrhage.Design And SettingCross-sectional study in a public university hospital in Elazig, Turkey.MethodsICU patients diagnosed with intracerebral hemorrhage and normal procalcitonin levels were included in this study. From clinical assessments and cultures, they were classified as presenting either infectious or central fever. The sensitivity and specificity of PCT and CRP for predicting infection were calculated using a receiver operating characteristic (ROC) curve.ResultsThere were 98 ICU patients with diagnoses of intracerebral hemorrhage. The median (interquartile range) PCT levels of patients with infectious and central fever were 4 (0.9-11) and 0.1 (0.1-0.4) ng/ml, respectively, with a statistically significant intergroup difference (P < 0.001). The areas under the ROC curve for predicting infectious or central fever PCT and CRP were 0.958 (P < 0.001) and 0.816 (P < 0.001), respectively. A statistically significant positive correlation was detected between PCT and CRP levels in patients with infectious fever (rho: 0.461; P = 0.003), but not in patients with central fever.ConclusionsPCT can possibly be used as a biomarker to differentiate between infectious and central fever among ICU patients.

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