Abstract
Procalcitonin (PCT) is a useful marker for systemic bacterial infection, and is considered to be closely correlated with the severity of sepsis. We encountered a patient with suspected neuroleptic malignant syndrome (NMS) who exhibited hyperprocalcitonemia in the absence of bacterial infection. The patient was a 66-year-old man with oropharyngeal carcinoma who was admitted to the hospital, and while hospitalized, he underwent gastrostomy as he was not able to eat properly. On postoperative day 3, the patient developed high fever, and blood biochemistry tests revealed elevated serum levels of CRP, PCT, and CK. Sepsis and rhabdomyolysis were suspected and the patient was admitted to the intensive care unit. Because the vital signs were stable, no foci of infection could be detected on physical examination, and the dose of haloperidol had been increased after the gastrostomy, NMS induced by dose escalation of a psychotropic drug was suspected. The serum CRP and PCT levels decreased with parenteral fluid management alone. In this case, although the cause of PCT elevation was not clarified, we should pay attention to the possibility of PCT elevation without systemic bacterial infections.
