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Review: acute serum procalcitonin levels may indicate pyelonephritis in children with febrile UTIs

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Question

In children with a febrile urinary tract infection (UTI) do serum procalcitonin (PCT) levels help diagnose pylonephritis?

Review scope

Studies were selected which compared PCT levels in children who presented with UTIs to the results of an acute dimercaptosuccinic acid (DMSA) scan. The majority of children had febrile UTIs.

Review methods

Cochrane Controlled Trials Register and Medline (to February 2009) were searched. Only studies in English, French, Spanish, German, Italian or Greek were included. Quality of studies was assessed by the QUADAS (quality assessment of studies of diagnostic accuracy in systematic reviews tool) criteria.Ten studies were included.

Main results

The 10 studies included 627 patients with culture proven UTI (68% female, age 2 months to 16 years). Blinding of study investigators was unclear in most cases. Meta-analysis showed that for a PCT >0.5–0.6 pg/ml, the average sensitivity was 85% (95% CI 71% to 93%)* and average specificity …

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