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Procalcitonin as a Severity-Based Risk Stratification Marker in Pediatric Infectious Diarrhea: A Prospective Study
Min-Jung Jan1, Chun-Yu Chen2,3, Yu-Jun Chang4
1Department of Medical Education, Tungs' Taichung MetroHarbor Hospital, Taichung 435, Taiwan.
Diagnostics (Basel, Switzerland)
|March 14, 2026
Summary
Procalcitonin (PCT) does not diagnose Salmonella in children with infectious diarrhea. However, elevated PCT levels in the emergency department (ED) strongly indicate disease severity, guiding hospitalization and treatment decisions.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Chemistry
- Emergency Medicine
Background:
- Procalcitonin (PCT) is increasingly used in emergency settings to evaluate febrile illnesses.
- The role of PCT in pediatric infectious diarrhea, especially as a severity marker, requires further clarification.
- Understanding PCT's utility can optimize emergency department (ED) assessments for pediatric gastrointestinal infections.
Purpose of the Study:
- To evaluate the correlation between procalcitonin (PCT) levels and clinical severity in children with infectious diarrhea presenting to the ED.
- To assess PCT's association with specific outcomes such as hospitalization, length of stay, and antibiotic use.
- To determine if PCT can serve as a marker for Salmonella enteritidis infection or disease severity.
Main Methods:
- A prospective study enrolled 105 children with infectious diarrhea in a tertiary pediatric ED.
- Serum PCT, C-reactive protein (CRP), clinical features, hydration status, and treatment decisions were analyzed.
- PCT cutoffs were evaluated for associations with Salmonella infection and severity measures (dehydration, hospitalization, length of stay, antibiotic use).
Main Results:
- PCT levels did not differ between Salmonella-positive and negative cases, showing poor diagnostic performance for Salmonella.
- Elevated PCT (≥ 0.25 ng/mL) was strongly associated with increased hospitalization rates (92.1% vs. 52.6%), longer hospital stays (4.41 vs. 3.00 days), and greater antibiotic use (66.7% vs. 23.7%).
- Higher PCT levels correlated with more dehydration, higher CRP, and overall increased treatment intensity.
Conclusions:
- Procalcitonin (PCT) is not a reliable diagnostic marker for Salmonella enteritidis in pediatric infectious diarrhea.
- PCT effectively reflects the host's inflammatory response and is a strong indicator of clinical severity in pediatric infectious diarrhea.
- Incorporating PCT thresholds into ED assessments can aid in early risk stratification, informing decisions on admission and treatment intensity.
