The Early Diagnosis of Gram Negative Septicemia in the Pediatric Surgical Patient
- 1 September 1975
- journal article
- Published by Wolters Kluwer Health in Annals of Surgery
- Vol. 182 (3) , 280-286
- https://doi.org/10.1097/00000658-197509000-00010
Abstract
Ninety-three postoperative patients 1 day to 13 years of age had blood cultures, limulus lysate assay, determination of fibrin degradation products, white blood cell and platelet counts. Seven groups were studied. The limulus lysate assay was often positive (64%) in the presence of gram negative septicemia but there were false positives and negatives. The tests for fibrin degradation products were inconsistent. The white blood cell count was low in babies with gram negative septicemia. One hundred per cent of the infants with gram negative septicemia had a platelet count below 150,000; 71% below 100,000 (average 67,000 septic babies, 257,000 non-septic babies). The drop in platelet count with gram negative septicemia was abrupt---as much as 222,000 in 24 hours. Platelets increased when therapy was effective. Two children with gram negative septicemia had platelet counts of 50,000 and 20,000. The platelet count for patients with gram positive septicemia was 299,000, and above 150,000 in all children with ruptured and non-ruptured appendicitis and major surgery without gram negative septicemia. It was concluded that serial measurements of platelet count in the postoperative infant and child was a rapid and reliable method for early detection of gram negative septicemia and changes in platelet count in response to treatment was an indicator of the effectiveness of therapy.Keywords
This publication has 16 references indexed in Scilit:
- Thrombocytopenia: Alaboratory sign of septicemia in infants and childrenThe Journal of Pediatrics, 1974
- The Limulus Test and Gram-Negative Bacillary SepsisArchives of Pediatrics & Adolescent Medicine, 1974
- Fibrin Degradation Products in the Postoperative Period: Evaluation of a New Latex Agglutination MethodAmerican Journal of Clinical Pathology, 1973
- Limitations of the Usefulness of the Limulus Assay for EndotoxinNew England Journal of Medicine, 1973
- Thrombocytopenia indicating gram-negative infection and endotoxemia.1973
- Clinical Experience on the Detection of Endotoxemia with the Limulus TestThe Journal of Infectious Diseases, 1973
- A Technique for Quantitative Measurement of Endotoxin in Human PlasmaExperimental Biology and Medicine, 1971
- Measurement of fibrinogen and fibrin degradation products in serum by staphylococcal clumping test.1970
- Platelet Counts with the Coulter CounterAmerican Journal of Clinical Pathology, 1965
- Immediate Effects of Intravenous Endotoxin on Serotonin Concentrations and Blood PlateletsCirculation Research, 1960