Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

Abeer Abdelkader; Reham Abdelkhalek; Hanaa Hosny; Mohamed Emara; Moustafa Elshamy

doi:10.5114/ceh.2023.127400

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

Abeer Abdelkader

¹

,

Reham Abdelkhalek

¹

,

Hanaa Hosny

¹

,

Mohamed H Emara

²

,

Moustafa Elshamy

¹

Faculty of Medicine, Zagazig University, Zagazig, Egypt
Faculty of Medicine, Kafrelsheikh University, Kafr El-Shikh, Egypt

Clin Exp HEPATOL 2023; 9, 2: 122–128

DOI: https://doi.org/10.5114/ceh.2023.127400

Online publish date: 2023/05/22

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Aim of the study:
Hepatocellular carcinoma (HCC) is a leading cause of mortality among patients with liver cirrhosis. According to the current practice guidelines, different ablations are used either as curative or palliative therapies. The current study aimed at determining bacterial infections as causes of fever and the predictive role of procalcitonin (PCT) among patients with HCC who had ablation therapy.

Material and methods:
This cross sectional study was carried out on 100 patients with HCC during the period from November 2019 to December 2021. All patients were evaluated by full history taking, clinical examination, complete blood picture (CBC), liver biochemistry, coagulation profile, kidney function, C-reactive protein (CRP), serum PCT and blood cultures. All were done for all participants at the 4th day follow-up after the procedures of ablation. HCC was treated according to the guidelines.

Results:
The frequency of fever after HCC ablation was 64% with variable intensities. Bacterial cultures were positive in 20 patients (20%). Twenty-four out of 100 patients had abnormally high PCT level. There was a highly statistically significant increase of PCT level in patients with a high CRP count and positive blood culture, p < 0.05. There was a statistically significant correlation between increased levels of PCT and levels of CRP, WBCs, albumin, AST, ALT, degree of fever, creatinine and BUN.

Conclusions:
Bacterial infection accounts for 20% of fever among HCC patients after ablation therapy. PCT is 100% sensitive and specific for detection of the bacterial causes of fever among those patients.

keywords:

Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

Abeer Abdelkader 1 , Reham Abdelkhalek 1 , Hanaa Hosny 1 , Mohamed H Emara 2 , Moustafa Elshamy 1

procalcitonin, bacterial infection, hepatocellular carcinoma, ablation therapy

Abeer Abdelkader

¹

,

Reham Abdelkhalek

¹

,

Hanaa Hosny

¹

,

Mohamed H Emara

²

,

Moustafa Elshamy

¹