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Elevated procalcitonin is associated with increased mortality in patients with scrub typhus infection needing intensive care admission.
[scrub typhus]
Procalcitonin
is
a
biomarker
of
bacterial
sepsis
.
It
is
unclear
if
scrub
typhus
,
a
rickettsial
illness
,
is
associated
with
elevated
procalcitonin
levels
.
To
assess
if
scrub
typhus
infection
is
associated
with
high
procalcitonin
levels
and
whether
high
levels
portend
a
poorer
prognosis
.
Retrospective
study
of
patients
with
severe
scrub
typhus
infection
,
admitted
to
the
medical
intensive
care
unit
of
a
tertiary
care
university
affiliated
teaching
hospital
.
Eighty
-
four
patients
with
severe
scrub
typhus
infection
that
also
had
procalcitonin
levels
were
assessed
.
Relationship
between
procalcitonin
and
mortality
explored
using
univariate
and
multivariate
analyses
.
The
mean
(
±
standard
deviation
)
age
was
40
.
0
±
15
.
5
years
.
Patients
were
symptomatic
for
8
.
3
±
4
.
3
days
prior
to
presentation
.
The
median
admission
procalcitonin
level
was
4
.
0
(
interquartile
range
1
.
8
to
8
.
5
)
ng
/
ml
;
59
(
70
.
2
%
)
patients
had
levels
>
2
ng
/
ml
.
Invasive
mechanical
ventilation
was
required
in
65
patients
;
20
patients
died
.
On
univariate
analysis
,
admission
procalcitonin
was
associated
with
increased
odds
of
death
[
odds
ratio
(
OR
)
1
.
09
,
95
%
confidence
interval
(
CI
)
1
.
03
to
1
.
18
]
.
On
multivariate
logistic
regression
analysis
including
procalcitonin
and
APACHE-
II
score
,
the
APACHE-
II
score
was
significantly
associated
with
mortality
(
OR
1
.
16
,
95
%
CI
1
.
06
to
1
.
30
,
P
=
0
.
004
)
while
a
trend
was
observed
with
procalcitonin
(
OR
1
.
05
,
95
%
CI
1
.
01
to
1
.
13
,
P
=
0
.
09
)
.
The
area
under
the
receiver
operating
characteristic
(
ROC
)
curve
,
AUC
,
for
mortality
was
0
.
77
for
procalcitonin
and
0
.
78
for
APACHE-
II
.
Procalcitonin
is
elevated
in
severe
scrub
typhus
infection
and
may
be
associated
with
higher
mortality
.
Diseases
Validation
Diseases presenting
"whether high levels portend a poorer prognosis"
symptom
scrub typhus
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