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The effect of microbiologic and clinical factors on procalcitonin levels*

	Rise >0.25 ng/mL	No rise or rise <0.25 ng/mL
Infections^¶
Bacterial
Typical respiratory bacteria	Most reported thus far
Atypical respiratory bacteria	Legionella spp	Chlamydia pneumoniae Mycoplasma pneumoniae
Mycobacteria	Mycobacteria spp^Δ	Mycobacteria spp^Δ
Other bacteria	Orientia tsutsugamushi (scrub typhus)	European Borrelia spp (Lyme borreliosis)
Viral
	None reported thus far	All reported thus far
Fungal
	Candida spp	Aspergillosis Coccidioidomycosis Mucormycosis
Parasitic
	Plasmodium spp (malaria)
Toxin-mediated illnesses	Severe Clostridioides difficile-associated disease^◊ Mushroom poisoning	C. difficile colonization
Severe physiologic stress	Burns Trauma Surgery Bowel ischemia Pancreatitis Intracerebral hemorrhage Ischemic stroke Shock of any kind (septic, anaphylactic, hemorrhagic, or cardiogenic)
Immune disorders and rheumatologic conditions	Kawasaki disease	Gout and pseudogout Inflammatory bowel disease Systemic lupus erythematosus Rheumatoid arthritis Granulomatosis with polyangiitis Still's disease Temporal arteritis Behçet syndrome Polyarteritis nodosa
Malignancies	Medullary thyroid cancer Lung cancers with neuroendocrine components	Lymphoma Sarcoma Pancreatic cancer Renal cell carcinoma
Other comorbidities	Renal insufficiency Severe liver disease
Drugs	Alemtuzumab (CD52 antibody) Granulocyte transfusions Interleukin 2 Rituximab (anti-CD20 antibody) T-cell antibodies	Glucocorticoids

* Conditions listed in this table are derived from case series and reports in the medical literature.

¶ Contained infections such as abscesses or empyema may not cause procalcitonin to rise.

Δ Both rise and lack of rise of procalcitonin have been reported with mycobacterial infections.

◊ Effect of C. difficile infection on procalcitonin levels not fully defined.

Data from:

Gilbert DN. Procalcitonin as a biomarker in respiratory tract infection. Clin Infect Dis 2011; 52 Suppl 4:S346.
Scheinpflug K, Schalk E, Grabert E, Achenbach HJ. Procalcitonin is not useful to discriminate between infectious and noninfectious CRP elevation in patients with non-small cell lung cancer. Infect Control Hosp Epidemiol 2015; 36:1117.
Rao K, Walk ST, Micic D, et al. Procalcitonin levels associate with severity of Clostridium difficile infection. PLoS One 2013; 8:e58265.
Li G, Zhu C, Li J, et al. Increased level of procalcitonin is associated with total MRI burden of cerebral small vessel disease in patients with ischemic stroke. Neurosci Lett 2018; 662:242.
He D, Zhang Y, Zhang B, et al. Serum procalcitonin levels are associated with clinical outcome in intracerebral hemorrhage. Cell Mol Neurobiol 2017.
Reinink AR, Limsrivilai J, Reutemann BA, et al. Differentiating Clostridium difficile colitis from Clostridium difficile colonization in ulcerative colitis: A role for procalcitonin. Digestion 2017; 96:207.
Grace E, Turner RM. Use of procalcitonin in patients with various degrees of chronic kidney disease including renal replacement therapy. Clin Infect Dis 2014; 59:1761.

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