Procalcitonin measurement in West Nile virus neuroinvasive disease: A first case series

Author:

Boehm Cheyanne1,Doig Christopher2,Chen Justin Z3,Sligl Wendy I34,Bagshaw Sean M45,Conly John6

Affiliation:

1. Department of Pharmacy Services, Alberta Health Services, Calgary, Alberta, Canada

2. Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada

3. Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada

4. Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada

5. Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada

6. Departments of Medicine, Pathology and Laboratory Medicine, Synder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, and Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, Alberta, Canada

Abstract

West Nile virus neuroinvasive disease (WNV-NID) is challenging to diagnose. Procalcitonin (PCT) is a useful diagnostic test to identify bacterial infections. We present four cases of WNV-NID with serum PCT measurements. Methods: Daily (days 1–7) serum PCT (bioMérieux) was examined for critically ill patients with sepsis enrolled in a provincial sepsis study. Patients with identified WNV-NID are descriptively analyzed in this case series. PCT values of ≥0.5 ng/mL were suggestive of bacterial infection. Results: Four patients with WNV-NID were identified. Those with viral infections alone had consistently low PCT values ranging from 0.09 ng/mL to 0.34 ng/mL. Those with documented bacterial co-infections had initially elevated PCT levels that decreased by more than 50% with antimicrobial therapy. Conclusion: These cases are the first to report serial PCT measurements in confirmed cases of WNV-NID and support a low serum PCT in WNV-NID.

Publisher

University of Toronto Press Inc. (UTPress)

Subject

Infectious Diseases,Microbiology (medical)

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