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Endotoxemia in febrile patients with hematological malignancies. Relationship of type of bacteremia, clinical findings and serum cytokine pattern

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Summary

The relation between gram-negative bacteremia, endotoxemia and cytokinemia in patients with hematological malignancies was studied. Serum endotoxin and cytokines (tumor necrosis factor-α, interleukin-1 receptor antagonist, interferon-γ, interleukin-6 and interleukin-10) were determined in 24 patients with hematological malignancies. Patients were included at start of fever (n=18) or during a temperature peak during continuous fever (n=6; time=0). Blood was drawn for cultures at time of inclusion. Additional samples were obtained and grouped in two time intervals (1–5 h and 6–12 h after inclusion). Endotoxin was detected in eight patients. Endotoxemia was more common among patients with bacteremia than among non-bacteremic patients (7/12 versus 1/12; p<0.05). All studied cytokines showed a tendency to higher mean values at time 0 in patients with endotoxemia than in patients without endotoxemia. Significantly higher mean endotoxin values were seen at time 1–5 h in patients with gram-negative bacteremia (n=6) than in patients without gram-negative bacteremia, and at time 0 in patients with chills (n=6) compared to those without chills.

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Authors and Affiliations

  1. Section of Hematology and Immunology, Dept. of Medicine, Sweden

    P. Engervall M. D., Ph. D. &  M. Björkholm M. D.

  2. Dept. of Microbiology, Sweden

    Marta Granström M. D.

  3. Section of Infectious Diseases, Dept. of Medicine, Karolinska Hospital, S-171 76, Stockholm

    M. Kalin M. D.

  4. CALAB Medical Laboratories, Box 15404, S-104 65, Stockholm, Sweden

    B. Andersson M. D.

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  1. P. Engervall M. D., Ph. D.
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  4. M. Kalin M. D.
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Engervall, P., Björkholm, M., Granström, M. et al. Endotoxemia in febrile patients with hematological malignancies. Relationship of type of bacteremia, clinical findings and serum cytokine pattern. Infection 25, 2–7 (1997). https://doi.org/10.1007/BF02113498

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