Procalcitonin in hantavirus infections

In hantavirus infections levels of serum leukocytes or C-reactive protein are usually elevated to levels found in serious bacterial infections. However, procalcitonin in patients infected with hantavirus has not yet been discussed in the literature. A total of 29 adult patients with hantavirus infection, 30 with sepsis, and 19 with tick-borne encephalitis were included in this observational retrospective study. The median procalcitonin level in patients with hantavirus infection was 0.53 mu mu g/L (range 0.09--11.71 mu mu g/L), in the group with sepsis 4.33 mu mu g/L (range 0.08--161.1 mu mu g/L) and in patients with viral meningitis 0.08 mu mu g/L (range 0.05--0.12 mu mu g/L). The difference between all three groups was statistically significant (p < 0.001). A higher procalcitonin level was found in patients with hemorrhagic fever with renal syndrome caused by Dobrava virus (0.74 mu mu g/L; range 0.09--2.83 mu mu g/L) than in those with Puumala virus infections (0.50 mu mu g/L; range 0.10--11.71 mu mu g/L). However, the difference was not statistically significant (p == 0.895). This study confirmed previous findings demonstrating the association of elevated procalcitonin with bacterial infection. However, increased procalcitonin serum level was also found in hantavirus infections with overlapping results between viral and severe bacterial infections.