Procalcitonin Level Compared to Total White Blood Cell Count and C-reactive Protein in Maxillofacial Space Infections - A Prospective Study.

Introduction: Orofacial space infections are potentially fatal and often need emergency medical and surgical care. Prompt diagnosis of these infections can sometimes be difficult because of diffuse swelling and trismus. Early treatment response is a key to the management and recovery. Conventional markers of infection, such as C-reactive protein (CRP) and white blood cell (WBC) counts fail to properly evaluate the progress. Procalcitonin (PCT) has high sensitivity and specificity for identifying bacterial infections and helps in treatment monitoring.

Materials and methods: After ethical committee approval, 20 cases of maxillofacial space infections who came to the Department of Oral and Maxillofacial Surgery with involvement of more than two spaces were included in the study. Demographic data and vital signs were recorded. Total WBC, CRP levels and PCT levels were measured at admission, 48 h and 96 h. The values were subjected to statistical analysis.

Results: The decrease in PCT values was found to be statistically significant (P < 0.05) when compared to the total WBC count and CRP values between admission/48 h period as well as 48/96-h periods, thus showing the positive response of patients to antibiotic therapy which was seen as clinical improvement.

Discussion: PCT succeeds as being a promising biomarker to determine the treatment response in maxillofacial space infections and guiding antibiotic regimen accordingly.