抄録
The clinical usefulness of the conventional limulus test (Toxicolor, which is activated not only by endotoxemia but also by fungemia) and the new test specific to endotoxin (Endospecy: ES test) was studied for the diagnosis of sepsis.
Among 131 blood samples from febrile patients suspected of having septicemia, 68 (51.9%) were positive with Toxicolor. Among 87 blood samples studied with both Toxicolor and blood culture simultaneously, 10 samples (11.5%) were microbiologically documented and determined to have endotoxemia. Thirty-two (36.8%) samples were microbiologically negative, but were positive with Toxicolor (endotoxemia and/or fungemia). Three samples (3.4%) were negative with Toxicolor but positive with blood culture. Of this group, one patient had gram-positive bacteremia and the other two had gram-negative bacteremia treated successfully with high dose steroid. Forty-two samples (48.3%) were negative with both Toxicolor and blood culture. These results indicate that among 74 patients with suspected septicemia without microbiological evidence, 32 patients (43.2%) were demonstrated to have sepsis with gram-negative bacteria or fungus.
Of 63 samples to which Toxicolor and Endospecy were applied, twenty-eight samples (44.4%) were positive with both tests, and 6 (9.5%) were positive with Toxicolor but negative with Endospecy. Among these 6 patients, 3 patients were proved to have fungal infection. The possibility of diagnosis of fungal infection was demonstrated by a combination of these two tests.
