Analysis of the Predictive Value of Procalcitonin and C-Reactive Protein for Coalescent Mastoiditis in Pediatric Patients: A Narrative Review

Hanief Rifqi Falih (Faculty of Medicine of Universitas Muhammadiyah Surakarta, Sukoharjo, Indonesia)
Hanimmatul Udmanurlaili (Faculty of Medicine of Universitas Muhammadiyah Surakarta, Sukoharjo, Indonesia)
Muhammad Adnan (Faculty of Medicine of Universitas Muhammadiyah Surakarta, Sukoharjo, Indonesia)
Raihan Daffa Al-Ghiffary (Faculty of Medicine of Universitas Muhammadiyah Surakarta, Sukoharjo, Indonesia)
Mumtaz Al-Mukaffa (Faculty of Medicine of Universitas Muhammadiyah Surakarta, Sukoharjo, Indonesia)
Dodik Nursanto (Faculty of Medicine of Universitas Muhammadiyah Surakarta, Sukoharjo, Indonesia)

Jurnal Implementa Husada (JIH)
Vol 7, No 1 (2026)

Abstract: Coalescent mastoiditis (CM) is a severe complication of acute otitis media in children for which definitive diagnosis requires a CT scan, creating a clinical need for non-invasive biomarkers. This narrative review aims to evaluate the roles of C-reactive protein (CRP) and procalcitonin (PCT) as predictors of CM. The methodology involved a structured literature search of databases including PubMed and Scopus for publications within the last five years (2020-2025). The results indicate that CRP is a reliable biomarker, with a level of ≥98.7 mg/L predicting the need for surgical intervention with 100% sensitivity and 74.6% specificity. Conversely, evidence for PCT is significantly lacking; indirect data suggest its levels do not consistently increase in localized infections such as CM. In conclusion, CRP is a validated and clinically useful biomarker for the risk stratification of CM in children, whereas the role of PCT remains unproven and appears to be limited.