The diagnostic performance of procalcitonin and neopterin as markers for bacterial and viral causes of fever was evaluated in a cohort of 69 febrile travellers with known etiological agents. Our aim was to establish a decision rule to minimize empirical antibiotic treatment. Compared with C-reactive protein (CRP) and leukocyte (differential) counts, procalcitonin and neopterin had a disappointing diagnostic accuracy. Refraining from antibiotics in case of combined presence of lymphocytosis and/or CRP ≤10. mg/l would result in an 85% reduction in unwanted antibiotic treatment in patients with viral disease but in adequate antibiotic coverage of all patients with bacterial disease.

CRP, Leukocyte differential counts, Neopterin, Procalcitonin, Travellers,
Royal Society of Tropical Medicine and Hygiene. Transactions
Department of Medical Microbiology and Infectious Diseases

te Witt, R, Hassing, R.J, Petit, P.P, van Belkum, A.F, & van Genderen, P.J.J. (2012). Procalcitonin and neopterin levels do not accurately distinguish bacterial from viral infections in ill-returned travellers with fever. Royal Society of Tropical Medicine and Hygiene. Transactions, 106(4), 264–266. doi:10.1016/j.trstmh.2012.01.001