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Adult-onset Still’s disease (AOSD) has been recognised as an important cause of fever of unknown origin. Over 99% of AOSD patients displayed fever during their disease course.1 The diagnosis of bacterial infection in febrile AOSD patients is challenging because traditional markers of infection are often misleading. This prompted us to search for a reliable marker that allows early discrimination between non-infectious inflammation and bacterial infection in febrile AOSD patients.
Procalcitonin, a novel marker that can distinguish disease activity from infection, has been investigated in febrile patients with systemic lupus erythematosus (SLE).2 3 Procalcitonin has proved to be a diagnostic marker of infection in critically ill patients compared with other inflammatory parameters.4 Serum procalcitonin is normally undetectable (<0.05 ng/ml) and procalcitonin levels of 0.5 ng/ml or greater can distinguish infection from non-infectious inflammation.3 5 Contradictory results for procalcitonin have recently been reported in …