Chest CT can be non-contrast here since you're really looking at the lung fields not the vasculature. Theoretically, you could look for PE w/ a CTA but I think you'd have timing issues with the CTA of the head. In general, procal is a test looking for a disease. I don't think you can use it to reliably rule out bacterial meningitis. There are articles out there supporting it's use but most are small and have significant methodological issues.
Hi Carlos, Chest CT without contrast will give you an idea if the patient has the pulmonary picture consistent with covid that many have seen in asymptomatic patients. Procalcitonin has been studied a lot over the years with regard to bacterial meningitis - here are a couple of PMIDs that you might find interesting. 28341167, 26994813, 22078647, 26096668
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Kenneth D. - May 15, 2020 10:42 AM
THANK YOU, SWAMI! At my institution they are COVID crazy and forget a lot of the other things that cause febrile illnesses, N/V, chest pain, etc.
Carlos G. - May 15, 2020 11:55 AM
Do you order the chest CT part with IV contrast?
Are you aware of any data of procalcitonin level in the setting of bacterial meningitis?
Anand S. - May 15, 2020 12:29 PM
Chest CT can be non-contrast here since you're really looking at the lung fields not the vasculature. Theoretically, you could look for PE w/ a CTA but I think you'd have timing issues with the CTA of the head.
In general, procal is a test looking for a disease. I don't think you can use it to reliably rule out bacterial meningitis. There are articles out there supporting it's use but most are small and have significant methodological issues.
Evie M. - May 16, 2020 7:47 AM
Hi Carlos, Chest CT without contrast will give you an idea if the patient has the pulmonary picture consistent with covid that many have seen in asymptomatic patients.
Procalcitonin has been studied a lot over the years with regard to bacterial meningitis - here are a couple of PMIDs that you might find interesting.
28341167, 26994813, 22078647, 26096668