The role of serum procalcitonin as a diagnostic marker in patients with dengue: a review
DOI:
https://doi.org/10.56782/pps.284Keywords:
dengue, procalcitonin, tropical diseases, hemorrhagic fever, diagnostic markerAbstract
Dengue is the most rapidly spreading vector-borne disease in the world. An estimated 2.5 billion people live in dengue-endemic countries. Most cases of dengue are asymptomatic; however, the disease can progress to a severe cases with plasma leakage, hemorrhage, and shock. The treatment options are limited and are focused mostly on supportive care. Procalcitonin is regarded as a biomarker specific for bacterial infections. The current literature contains only five papers addressing the topic of the clinical relevance of serum procalcitonin in patients with dengue. Serum procalcitonin levels tend to be elevated in patients who experience organ failure, shock, or dengue hemorrhagic fever; however, this difference was not statistically significant in all studies. Serum procalcitonin demonstrated strong diagnostic utility for detecting bacterial coinfection or bacteremia, and can be used to exclude bacteremia in dengue patients. The majority of the reviewed studies involved small sample sizes, which often precluded reaching statistical significance. The utility of serum procalcitonin as a diagnostic marker in patients with dengue remains insufficiently explored, and further research is necessary to fully understand its clinical role.
Downloads
References
1. WHO and TDR. Dengue guidelines, for diagnosis, treatment, prevention and control, 3rd ed.; World Health Organization: Geneva, Switzerland, 2009; pp. 3-10.
2. Wang, W.H.; Urbina, A.N.; Chang, M.R., et al. Dengue hemorrhagic fever - A systemic literature review of current perspectives on pathogenesis, prevention and control. J. Microbiol. Immunol. Infect. 2020, 53(6), 963-978. DOI: 10.1016/J.JMII.2020.03.007 DOI: https://doi.org/10.1016/j.jmii.2020.03.007
3. Murugesan A.; Manoharan M. Dengue Virus. In: Emerging and Reemerging Viral Pathogens, Ed. Moulay Mustapha Ennaji, Academic Press, 2020, Volume 1: Fundamental and Basic Virology Aspects of Human, Animal and Plant Pathogens, pp. 281-359. DOI: 10.1016/B978-0-12-819400-3.00016-8 DOI: https://doi.org/10.1016/B978-0-12-819400-3.00016-8
4. Dengue - Global situation. Available online: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498 (accessed on 9 October 2024)
5. Pancer K.; Szkoda, M.T.; Gut, W. Imported cases of dengue in Poland and their diagnosis. Przegl. Epidemiol. 2014, 68, 651-655.
6. Dengue | CDC Yellow Book 2024. Available online: https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/dengue (accessed 9 October 2024)
7. Gwee, X.W.S.; Chua, P.E.Y.; Pang, J. Global dengue importation: a systematic review. BMC Infect. Dis. 2021, 21(1), Art. No: 1078. DOI: 10.1186/S12879-021-06740-1
8. Junxiong, P.; Yee-Sin, L. Clustering, climate and dengue transmission. Expert Rev. Anti. Infect. Ther. 2015, 13(6), 731-740. DOI:10.1586/14787210.2015.1028364 DOI: https://doi.org/10.1586/14787210.2015.1028364
9. Nakase, T.; Giovanetti, M.; Obolski, U. et al. Population at risk of dengue virus transmission has increased due to coupled climate factors and population growth. Commun. Earth Environ. 2024, 5(1), Art. No: 475. DOI: 10.1038/s43247-024-01639-6 DOI: https://doi.org/10.1038/s43247-024-01639-6
10. De Santis, O.; Bouscaren, N.; Flahault, A. Asymptomatic dengue infection rate: A systematic literature review. Heliyon 2023, 9(9), Art. No: e20069. DOI: 10.1016/J.HELIYON.2023.E20069 DOI: https://doi.org/10.1016/j.heliyon.2023.e20069
11. Frazer, J.L.; Norton, R. Dengue: A review of laboratory diagnostics in the vaccine age. J. Med. Microbiol. 2024, 73(5). DOI: 10.1099/JMM.0.001833 DOI: https://doi.org/10.1099/jmm.0.001833
12. Vachvanichsanong, P.; Thisyakorn, U.; Thisyakorn, C. Dengue hemorrhagic fever and the kidney. Arch. Virol. 2016, 161(4), 771-778. DOI: 10.1007/S00705-015-2727-1 DOI: https://doi.org/10.1007/s00705-015-2727-1
13. Tejo, A.M.; Hamasaki, D.T.; Menezes, L.M. et al. Severe dengue in the intensive care unit. J. Intensive Med. 2024, 4(1), 16-33. DOI: 10.1016/J.JOINTM.2023.07.007 DOI: https://doi.org/10.1016/j.jointm.2023.07.007
14. Kala, M.P.; John, A.L. St.; Rathore, A.P.S. Dengue: Update on Clinically Relevant Therapeutic Strategies and Vaccines. Curr. Treat. Options Infect. Dis. 2023, 15(2), 27-52. DOI: 10.1007/S40506-023-00263-W DOI: https://doi.org/10.1007/s40506-023-00263-w
15. Endy, T.P. Viral Febrile Illnesses and Emerging Pathogens. In: Hunter’s Tropical Medicine and Emerging Infectious Diseases. Ryan, E.T.; Hill, D.R.; Solomon, T.; Aronson, N.E.; Endy, T.P. Eds. Elsevier Inc. 2020, pp. 325-350. DOI: 10.1016/B978-0-323-55512-8.00036-3 DOI: https://doi.org/10.1016/B978-0-323-55512-8.00036-3
16. Samsudin, I., Vasikaran, S.D. Clinical Utility and Measurement of Procalcitonin. Clin. Biochem. Rev. 2017, 38(2), 59-68.
17. Hamade, B.; Huang, D.T. Procalcitonin: Where Are We Now? Crit. Care Clin. 2020, 36(1), 23-40. DOI: 10.1016/J.CCC.2019.08.003 DOI: https://doi.org/10.1016/j.ccc.2019.08.003
18. Chambliss, A.B.; Patel, K.; Colón-Franco, J.M. et al. AACC Guidance Document on the Clinical Use of Procalcitonin. J. Appl. Lab. Med. 2023, 8(3), 598-634. DOI: 10.1093/JALM/JFAD007 DOI: https://doi.org/10.1093/jalm/jfad007
19. Zeng, J.T.; Wang, Y.; Wang, Y. et al. Elevated procalcitonin levels in the absence of infection in procalcitonin-secretin hepatocellular carcinoma: A case report. World J. Clin. Cases 2022, 10(29), 10811-10816. DOI: 10.12998/WJCC.V10.I29.10811 DOI: https://doi.org/10.12998/wjcc.v10.i29.10811
20. Heidari-Beni, F.; Vahedian-Azimi, A.; Shojaei, S. et al. The Level of Procalcitonin in Severe COVID-19 Patients: A Systematic Review and Meta-Analysis. Adv. Exp. Med. Biol. 2021, 1321, 277-286. DOI: 10.1007/978-3-030-59261-5_25 DOI: https://doi.org/10.1007/978-3-030-59261-5_25
21. Gautam, S.; Cohen, A.J.; Stahl, Y. et al. Severe respiratory viral infection induces procalcitonin in the absence of bacterial pneumonia. Thorax 2020, 75(11), 974-981. DOI: 10.1136/THORAXJNL-2020-214896 DOI: https://doi.org/10.1136/thoraxjnl-2020-214896
22. Sani, H.; Syazana, N.; Izuan, Z. et al. Procalcitonin and clinical factors associated with severe dengue infection in hospitalized adults in Malaysia. American Journal of Infectious Diseases. 2019, 15(4), 103-110. DOI: 10.3844/ajidsp.2019.103.110 DOI: https://doi.org/10.3844/ajidsp.2019.103.110
23. Thanachartwet, V.; Desakorn, V.; Sahassananda, D. et al. Serum Procalcitonin and Peripheral Venous Lactate for Predicting Dengue Shock and/or Organ Failure: A Prospective Observational Study. PLoS Negl. Trop. Dis. 2016, 10(8), Art. No: e0004961. DOI: 10.1371/journal.pntd.0004961 DOI: https://doi.org/10.1371/journal.pntd.0004961
24. Ajantha Shyamali, N.L.; Mahapatuna, S.D.; Gomes, L. et al. Risk Factors for Elevated Serum Lipopolysaccharide in Acute Dengue and Association with Clinical Disease Severity. Trop. Med. Infect. Dis. 2020, 5(4), Art. No: 170. DOI: 10.3390/tropicalmed5040170 DOI: https://doi.org/10.3390/tropicalmed5040170
25. Azmi, W.N.A.W.; Shukeri, W.F.W.M.; Nor, M.B.M. et al. Point-of-care procalcitonin for early detection of bacterial coinfection in patients with severe dengue admitted to the intensive care units. Anaesth. Pain Intensi. 2022, 26(4), 523-529. DOI: 10.35975/apic.v26i4.1960 DOI: https://doi.org/10.35975/apic.v26i4.1960
26. Chen, C.M.; Chan, K.S.; Chao, H.C. et al. Diagnostic performance of procalcitonin for bacteremia in patients with severe dengue infection in the intensive care unit. J. Infect. 2016, 73(1), 93-95. DOI: 10.1016/J.JINF.2016.03.013 DOI: https://doi.org/10.1016/j.jinf.2016.03.013
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Szymon Barczak, Zuzanna Hertz, Barbara Badura
This work is licensed under a Creative Commons Attribution 4.0 International License.
For all articles published in Prospects in Pharmaceutical Sciences copyright is retained by the authors. The journal publishes articles in the Open Access policy, within the CC BY 4.0 licence.
This is a human-readable summary of (and not a substitute for) the license. Disclaimer.
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
How to Cite
