Procalcitonin as an early marker of infection in neonates and children

Lancet Infect Dis. 2004 Oct;4(10):620-30. doi: 10.1016/S1473-3099(04)01146-6.


A child or neonate presenting with fever is a common medical problem. To differentiate between those with a severe bacterial infection and those with a localised bacterial or a viral infection can be a challenge. This review provides an overview of neonatal and paediatric studies that assess the use of procalcitonin as an early marker of bacterial infection. Procalcitonin is an excellent marker for severe, invasive bacterial infection in children. However, the use of procalcitonin in the diagnosis of neonatal bacterial infection is complicated, but if correctly used procalcitonin results in a higher specificity than C-reactive protein. In addition, procalcitonin has been shown to correlate with severity of disease (urinary tract infections and sepsis), and can therefore be used as a prognostic marker. Procalcitonin is therefore a useful additional tool for the diagnosis of bacterial disease in neonates and children.

Publication types

  • Review

MeSH terms

  • Bacteremia / blood
  • Bacteremia / diagnosis
  • Bacterial Infections / blood
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / microbiology
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Child
  • Child, Preschool
  • Early Diagnosis
  • Fever / blood
  • Fever / microbiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Meningitis / blood
  • Meningitis / diagnosis
  • Predictive Value of Tests
  • Prognosis
  • Protein Precursors / blood*
  • Respiratory Tract Infections / blood
  • Respiratory Tract Infections / diagnosis
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Urinary Tract Infections / blood
  • Urinary Tract Infections / diagnosis


  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide