Procalcitonin - Biochemistry and Clinical Diagnosis

1. Basic information 91.1. Procalcitonin, a marker protein for infection and sepsis 91.2. Properties of PCT 101.3. Diagnosis of severe bacterial infections and sepsis 101.4. PCT and severity of disease 101.5. Non-bacterial causes of elevated PCT levels 121.6. Prognostic significance and evaluation of the progression of sepsis 121.7. Influence on diagnostic and therapeutic decisions during the clinical visit 141.8. Indication and monitoring of antibiotic therapy 151.9. Stability and kinetics of PCT 151.10. An overview of biochemical properties 162. Primary indications 172.1. Diagnosis, progression evaluation, and therapy of bacterial infections and sepsis 172.1.1. Diagnosis of sepsis, severe sepsis, and septic shock 172.1.2. Differential diagnosis of severe bacterial infection and sepsis 192.1.3. Evaluation of the severity of sepsis and the systemic inflammatory reaction 222.1.4. Progression and prognostic significance 232.1.5. Indication and control of antibiotic treatment 252.2. PCT level measurement in specific clinical areas 262.2.1. PCT in the intensive care unit 262.2.2. PCT in the emergency room 272.2.3. PCT in outpatient cases 303. Biochemistry, pathophysiology 333.1. Procalcitonin (PCT), a soluble protein 333.2. Genetics 343.3. Mechanisms of induction and elimination of PCT 353.4. Time behavior of induction and elimination 363.5. Biological effects of PCT 364. Laboratory chemistry 394.1. Methods of PCT level measurement 394.2. Stability and half-life in vitro, preanalytical factors 394.3. Normal values and reference ranges of PCT 395. PCT as a marker of infection and sepsis: an evidence-based collection of data 405.1. Differential diagnosis of bacterial infections: SIRS and sepsis 405.2. PCT as a marker of the progression of infection to sepsis, severe sepsis and septic shock 455.3. Interpretation of PCT in the clinical context 465.4. PCT: a marker of infection or of inflammation? 465.5. Comparison with other markers 486. Use of PCT for the control of