High cytokine levels at admission are associated with fatal outcome in patients with necrotizing fasciitis.
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| Abstract |
We evaluated in a blinded fashion the cytokine profiles of patients with suspected necrotizing fasciitis. In 15 out of 20 patients, the diagnosis of necrotizing fasciitis was established; five patients had cellulitis. Eighteen of the 20 patients were i.v. drug users. Five of the 15 patients with necrotizing fasciitis died (33%). On admission, serum levels for interleukin-1beta (IL-1beta), IL-1-receptor antagonist (IL-1Ra), IL-18 and interferon-gamma (IFNgamma) as well as white blood cells (WBC) were significantly elevated in patients with fatal outcome compared to survivors with necrotizing fasciitis. IL-1Ra and WBC levels were also higher than in patients with cellulitis. No differences were observed between patients groups for IL-6 and IL-8. In summary, significantly elevated levels of proinflammatory cytokines and particularly IL-1Ra are associated with fatal outcome in patients with necrotizing fasciitis. The measurement of proinflammatory cytokines and IL-1Ra may help to establish early diagnosis of life-threatening necrotizing fasciitis and thus to initiate aggressive treatment.
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| Authors | Kathrin Lungstras-Bufler, Philip Bufler, Rabiatu Abdullah, Christine Rutherford, Stefan Endres, Edward Abraham, Charles A Dinarello, Robert M Rodriguez |
| Journal | European cytokine network (Eur Cytokine Netw) 2004 Apr-Jun Vol. 15 Issue 2 Pg. 135-8 ISSN: 1148-5493 [Print] France |
| PMID | 15319173 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.) |
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