ArticleCureus2026
Comparative Analysis of Procalcitonin and C-Reactive Protein in Bloodstream Infections Among Febrile Neutropenic Pediatric Cancer Patients.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Febrile neutropenia is a serious complication in pediatric cancer patients receiving chemotherapy, often leading to bloodstream infections, where early diagnosis is critical. This prospective observational study, conducted at a tertiary care hospital in Northern India from August 2023 to July 2024, included 106 pediatric patients with chemotherapy-induced febrile neutropenia to compare the diagnostic performance of procalcitonin (PCT) and C-reactive protein (CRP). Bloodstream infections were confirmed in 32 patients (30.2%), comprising 20 Gram-negative, 11 Gram-positive, and one fungal isolate. PCT levels were significantly higher in Gram-negative infections (19.27 ± 10.56 ng/mL) than in Gram-positive infections (2.57 ± 2.35 ng/mL, p<0.01), while CRP showed less specificity (150.0 ± 35.2 mg/L vs. 45.0 ± 20.8 mg/L, p<0.05). PCT demonstrated superior diagnostic accuracy (sensitivity 89.2%, specificity 83.5%, AUC 0.93) compared to CRP (sensitivity 76.3%, specificity 62.7%, AUC 0.76). Elevated PCT levels correlated with higher intensive care admissions, prolonged hospital stays, and delayed antibiotic de-escalation (p<0.001). These findings indicate that PCT is a more reliable biomarker than CRP for early detection of bloodstream infections in febrile neutropenic pediatric cancer patients, particularly for Gram-negative bacteremia, and its routine incorporation may enhance infection management and clinical outcomes in pediatric oncology.
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