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Current Issue - July 2023, Volume 17, Issue No. 2

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Serum Procalcitonin (PCT) - Is there a Role as an Early Biomarker in Infected Diabetic Foot Ulcer (IDFU) Patients?


  1. Umapathy D, Dornadula S, Rajagopalan A, Murthy N, Mariappanadar V, Kesavan R, et al. Potential of circulatory procalcitonin as a biomarker reflecting inflammation among South Indian diabetic foot ulcers. J Vasc Surg. 2018; 67(4): 1283-91.e2. doi: 10.1016/j.jvs.2017.02.060
  2. Massara M, De Caridi G, Serra R, Barilla D, Cutrupi A, Volpe A, et al. The role of procalcitonin as a marker of diabetic foot ulcer infection. Int Wound J. 2017; 14(1): 31-4. doi: 10.1111/iwj.12536
  3. Atosona A, Larbie C. Prevalence and Determinants of Diabetic Foot Ulcers and Lower Extremity Amputations in Three Selected Tertiary Hospitals in Ghana. J Diabetes Res. 2019; 2019: 7132861. doi: 10.1155/2019/7132861
  4. Al Kafrawy NAEF, Mustafa EAAEA, Abd El-Salam Dawood AED, Ebaid OM, Zidane OMA. Study of risk factors of diabetic foot ulcers. Menoufia Med J. 2014; 27(1): 28. doi: 10.4103/1110-2098.132298
  5. Efat K, Morteza D, Allameh SF, Mehrnaz A, Manoochehr N, Alireza A. Diagnostic Value of Serum Procalcitonin Level for Detecting Infected Diabetic Foot Ulcers. Ann Med Health Sci. 2018; 8(1): 79-81.
  6. Park JH, Suh DH, Kim HJ, Lee YI, Kwak IH, Choi GW. Role of procalcitonin in infected diabetic foot ulcer. Diabetes Res Clin Pract. 2017; 128: 51-7. doi: 10.1016/j.diabres.2017.04.008
  7. Greeff E. Is procalcitonin useful in diagnosing septic arthritis and osteomyelitis in children? SA Orthop J. 2012; 11(1): 52-6.
  8. Meisner M. Update on procalcitonin measurements. Ann Lab Med. 2014; 34(4): 263-73. doi: 10.3343/alm.2014.34.4.263
  9. Khan F. High Serum Procalcitonin: Interpret with Caution. Clin Microbiol. 2017; 6(2): e141. doi: 10.4172/2327-5073.1000e141
  10. Schuetz P, Christ-Crain M, Muller B. Procalcitonin and other biomarkers to improve assessment and antibiotic stewardship in infections--hope for hype? Swiss Med Wkly. 2009; 139(23-24): 318-26. doi: 10.4414/smw.2009.12584
  11. Gonzalez-Busto Mugica I, Prieto Rodriguez J, Fernandez Fernandez A, Hueso Rieu R, Alvarez Menendez FV, Amigo Fernandez A. Procalcitonin in the diagnosis of postoperative infection in knee arthroplasty. Rev Esp Cir Ortop Traumatol. 2011; 55(2): 130-9. doi: 10.1016/s1988-8856(11)70295-4
  12. Samsudin I, Vasikaran SD. Clinical Utility and Measurement of Procalcitonin. Clin Biochem Rev. 2017; 38(2): 59-68.
  13. Velissaris D, Pantzaris ND, Platanaki C, Antonopoulou N, Gogos C. Procalcitonin as a diagnostic and prognostic marker in diabetic foot infection. A current literature review. Rom J Intern Med. 2018; 56(1): 3-8. doi: 10.1515/rjim-2017-0039
  14. Wacker C, Prkno A, Brunkhorst FM, Schlattmann P. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infect Dis. 2013; 13(5): 426-35. doi: 10.1016/S1473-3099(12)70323-7
  15. Korkmaz P, Kocak H, Onbasi K, Bicici P, Ozmen A, Uyar C, et al. The Role of Serum Procalcitonin, Interleukin-6, and Fibrinogen Levels in Differential Diagnosis of Diabetic Foot Ulcer Infection. J Diabetes Res. 2018; 2018: 7104352. doi: 10.1155/2018/7104352
  16. Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014; 12(12): 1500-24. doi: 10.1016/j.ijsu.2014.07.014
  17. World Health Organization (WHO). HEARTS D: Diagnosis and management of type 2 diabetes. 2020. (accessed on 25 April 2020)
  18. Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012; 54(12): e132-73. doi: 10.1093/cid/cis346
  19. Mehraj DM. A review of Wagner classification and current concepts in management of diabetic foot. Int J Orthop Sci. 2018; 4(1): 933-5. doi: doi: 10.22271/ortho.2018.v4.i1n.133
  20. Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012; 24(3): 69-71.
  21. Rogic D, Juros GF, Petrik J, Vrancic AL. Advances and Pitfalls in Using Laboratory Biomarkers for the Diagnosis and Management of Sepsis. EJIFCC. 2017; 28(2): 114-21.
  22. Jeandrot A, Richard JL, Combescure C, Jourdan N, Finge S, Rodier M, et al. Serum procalcitonin and C-reactive protein concentrations to distinguish mildly infected from non-infected diabetic foot ulcers: a pilot study. Diabetologia. 2008; 51(2): 347-52. doi: 10.1007/s00125-007-0840-8
  23. Uzun G, Solmazgul E, Curuksulu H, Turhan V, Ardic N, Top C, et al. Procalcitonin as a diagnostic aid in diabetic foot infections. Tohoku J Exp Med. 2007; 213(4): 305-12. doi: 10.1620/tjem.213.305
  24. Zakariah NA, Bajuri MY, Hassan R, Ismail Z, Md Mansor M, Othman H, et al. Is Procalcitonin more superior to hs-CRP in the diagnosis of infection in diabetic foot ulcer? Malays J Pathol. 2020; 42(1): 77-84.
  25. Van Asten SA, Nichols A, La Fontaine J, Bhavan K, Peters EJ, Lavery LA. The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis. Int Wound J. 2017; 14(1): 40-5. doi: 10.1111/iwj.12545
  26. Reiner MM, Khoury WE, Canales MB, Chmielewski RA, Patel K, Razzante MC, et al. Procalcitonin as a Biomarker for Predicting Amputation Level in Lower Extremity Infections. J Foot Ankle Surg. 2017; 56(3): 484-91. doi: 10.1053/j.jfas.2017.01.014
  27. Altay FA, Sencan I, Senturk GC, Altay M, Guvenman S, Unverdi S, et al. Does treatment affect the levels of serum interleukin-6, interleukin-8 and procalcitonin in diabetic foot infection? A pilot study. J Diabetes Complications. 2012; 26(3): 214-8. doi: 10.1016/j.jdiacomp.2012.03.018
  28. Jonaidi Jafari N, Safaee Firouzabadi M, Izadi M, Safaee Firouzabadi MS, Saburi A. Can procalcitonin be an accurate diagnostic marker for the classification of diabetic foot ulcers? Int J Endocrinol Metab. 2014; 12(1): e13376. doi: 10.5812/ijem.13376
  29. Al-Shammaree SAW, Abu-ALkaseem BA, Salman IN. Procalcitonin levels and other biochemical parameters in patients with or without diabetic foot complications. J Res Med Sci. 2017; 22: 95. doi: 10.4103/jrms.JRMS_906_16
  30. Meloni M, Izzo V, Giurato L, Brocco E, Ferrannini M, Gandini R, et al. Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection. J Diabetes Res. 2019; 2019: 4312737. doi: 10.1155/2019/4312737
  31. Leli C, Ferranti M, Moretti A, Al Dhahab ZS, Cenci E, Mencacci A. Procalcitonin levels in gram-positive, gram-negative, and fungal bloodstream infections. Dis Markers. 2015; 2015: 701480. doi: 10.1155/2015/701480

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The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

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