Procalcitonin Patterns in Sepsis: An Indian Insight into Tropical Infections | Chapter 12 | An Overview of Disease and Health Research Vol. 5

 

Background: Sepsis remains a critical global health challenge, particularly in tropical regions where diverse pathogens—ranging from bacteria and fungi to malaria and dengue—trigger complex host responses.

 

Aim: This study aimed to characterise procalcitonin (PCT) dynamics in sepsis patients, with a special focus on tropical infections, at a rural teaching hospital in India.

 

Methods: A cross-sectional study was conducted at the Microbiology and General Medicine departments of SBKS Medical Institute & Research Centre, Sumandeep Vidyapeeth, between September 2012 and December 2015. After ethical approval, we enrolled 155 adult patients (aged >18 years) clinically diagnosed with sepsis (according to the 1992/2001 definitions). Initial PCT measurement employed a semi-quantitative assay (until March 2015), later transitioned to a QDx Instacheck quantitative method. Patients were categorised by aetiology: 98 tropical sepsis, 46 non-tropical sepsis, and 11 with unidentified causes.

 

Results: PCT levels on admission were distributed as follows: ≤0.5 ng/mL in 43 patients, >0.5 to <2 ng/mL in 32, ≥2 to <10 ng/mL in 55, and ≥10 ng/mL in 25. The majority exhibited PCT in the 2–10 ng/mL range. Elevated PCT (≥2 ng/mL) was common across bacterial, fungal, and malarial infections, whereas dengue cases predominantly had PCT ≤0.5 ng/mL. Peak PCT levels (≥10 ng/mL) were strongly associated with severe disease and higher mortality.

 

Conclusions: In the rural Indian cohort, PCT elevation was not specific enough to distinguish among bacterial, fungal, and malarial sepsis but proved highly indicative of dengue when levels remained ≤0.5 ng/mL. Exceptionally high PCT correlated with disease severity and mortality. These findings underscore PCT’s potential as a rapid biomarker to guide early diagnostic assessments and risk stratification in tropical sepsis settings—and particularly for identifying dengue cases with low PCT.

 

 

Author(s) Details

Hairya Ajaykumar Lakhani
SBKS Medical Institute and Research Centre, Vadodara, India.

 

Aarjuv Majmundar
Department of Medicine, SBKS Medical Institute and Research Centre, Vadodara, India.

 

Miloni Mineshbhai Nada
Surat Municipal Institute of Medical Education and Research (SMIMER), Affiliated to the Veer Narmad South Gujarat University, Surat, India.

 

Radhika Khara
Department of Microbiology, Banas Medical College & Research Institute, Palanpur, India.

 

Sucheta Lakhani
Department of Microbiology, SBKS Medical Institute and Research Centre, Vadodara, India.

 

Jitendra D. Lakhani
Department of Medicine, SBKS Medical Institute and Research Centre, Vadodara, India.

 

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