[Unusual cause of a PCT-elevation].

INTRODUCTION

Procalcitonin (PCT) is an established marker for bacterial infection. Elevation of PCT can occur due to various reasons and is not specific, as we outline in the following case report.

HISTORY: We report on a 29 year old patient, who was presented by the psychiatric department because of obscure abdominal pain, nausea and vomiting since two days. Taking the patients history did not result in conclusive findings at first.

FINDINGS AND DIAGNOSIS: The clinical examination did not result in conclusive findings. The patient was afebrile. Blood work showed an elevation of transaminases and a massive elevation of PCT. In ultrasound no abnormalities were shown, serological investigations for viral hepatitis were negative. Blood cultures remained sterile, the search for an infectious focus remained unremarkable.

THERAPY AND COURSE: In the course of the in-patient stay the patient reported the ingestion of approximately 40 g of acetaminophen in suicidal intention two days before. Therapy with N-acetylcysteine (NAC) was initiated. The transaminases and PCT were regressive the next day. Antibiotic therapy was foregone.

CONCLUSIONS

This case illustrates that PCT-elevation is not specific for a bacterial infection and must be seen in correlation to patient's history and clinical findings.