Procalcitonin as an early diagnostic marker for ventriculoperitoneal shunt infections

Background: Procalcitonin (PCT) has been considered a more reliable marker than others because of its specificity for bacterial infection. Methods: Case report and review of the literature. Results: A 50-year-old male was diagnosed with subarachnoid hemorrhage, intraventricular hemorrhage, and intracerebral hemorrhage. We performed a ruptured aneurysm clipping and left unilateral external ventricular drainage. We also performed ventriculoperitoneal (VP) shunt placement in the course; however, VP shunt infection was indicated by fever, increased C-reactive protein concentration and leukocytosis. The cerebrospinal fluid culture showed methicillin-resistant Staphylococcus epidermidis but the serum PCT concentration was quite low. Conclusions: Although PCT is considered a more reliable serological marker of bacterial meningitis in several reports, the serum PCT concentration did not reflect the bacterial VP shunt infection that was present in our case.