Procalcitonin and pyelonephritis in children.

PURPOSE OF REVIEW: In the past few years, procalcitonin has been proposed as a sensitive and specific inflammatory marker in various fields of medicine, especially in infectivology, where it has been used to discriminate between bacterial infections, viral infections and inflammation processes. Recently, different studies have emerged in the literature on the use of this marker to identify renal involvement in febrile urinary tract infections.

RECENT FINDINGS: Procalcitonin seems to be a valid biological marker, with an acceptable sensitivity and specificity, which predicts a renal involvement of the infection (pyelonephritis), in comparison with the low specificity of C-reactive protein. Procalcitonin also seems to be correlated with the degree of the involvement at the moment of diagnosis of febrile urinary tract infections and with scarring.

SUMMARY: Renal involvement has always been the main diagnostic objective in children with febrile urinary tract infections. If more studies confirm the correlation between procalcitonin, renal involvement during urinary infections and scar formation, we will finally have a noninvasive tool that can identify children at risk of complications and in need of a close follow-up as early as their first episode of febrile urinary tract infection.