Source: Annual Congress 2012 - Prognostic indices in respiratory infections
Disease area: Respiratory infections

Abstract

INTRODUCTION
It is a controversial matter if virus alone, without a copathogen is able to cause pneumonia in immuncompetent adults. We studied leukocyte count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) serum levels to test their behaviour in each etiologic group.
MATERIALS AND METHODS
In a prospective study, we obtained serum CRP, PCT, WBC and PADM from 282 patients with CAP at their admittance. A complete test battery was performed, including two multiple polimerase chain reaction (PCR) for respiratory viruses.
RESULTS
PCT had significant higher levels in bacteria-involved CAP (bacterial an mixed) than viral/atypical ones. Mixed bacterial/viral CAP had a similar value for PCT, whereas viral pneumonias showed lower PCT levels. CRP values were also different between viral and mixed CAP. When Influenza was removed from viral group, differences were maintained. ROC curve to try to discriminate bacteria-involved from viral CAP, had an AUC for PCT of 0.658 (p<0,001).

CONCLUSION
Biomarkers CRP and specially, PCT have a different behavior in viral than mixed bacterial/virus CAP, even without including Influenza. That suggests that viruses can be, without associated copathogen, cause of CAP.
Levels of PCT are similar in bacterial CAP than mixed virus/bacterial CAP, and higher than the viral pneumonia ones, and it can help us to differentiate bateria-involved pneumonia from viral CAP.

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E. Minchole, S. Fandos, A. Simon, C. Panadero, A. Lasierra, M.A. Ruiz, G. Hernandez, D. Nieto, C. Viñado, S. Bello (Zaragoza, Spain). Biomarkers and community-adquired pneumonia (CAP) etiology. Eur Respir J 2012; 40: Suppl. 56, 2528

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