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PubMed1977

[Neutrophil damage index (NDI test) and leukocytosis response in the diagnosis of scleroma].

Clinical, bacteriologica and serological study was carried out in 57 patients with various forms of scleroma. In the same patients and also in 35 donors and 10 persons suffering from other ENT diseases a study was made of the allergy test (the NDI test) and the leukocytolysis test. Various microbial preparations were approbated, specificity of phenolen was studied. A possibility of using the mentioned allergy test in the capacity of an auxillary method in laboratory diagnosis of scleroma was demonstrated.

Humans↗
PubMed2000

Pathogenesis of abnormal vaginal bacterial flora.

OBJECTIVE: This study was undertaken to determine the relationships between microscopy findings on wet mounts, such as lactobacillary grade or vaginal leukocytosis, and results of vaginal culture, lactate and succinate content of the vagina, and levels of selected cytokines. STUDY DESIGN: In a population of 631 unselected women seeking treatment at an obstetrics and gynecology outpatient clinic, vaginal fluid was obtained by wooden Ayre spatula for wet mounting and pH measurement, by high vaginal swab for culture, and by standardized vaginal rinsing with 2 mL 0.9% sodium chloride solution for measurements of lactate, succinate, interleukin 1beta, interleukin 8, leukemia inhibitory factor, and interleukin 1 receptor antagonist concentrations. Lactate and succinate levels were measured by gas-liquid chromatography and the cytokine concentrations were measured by specific immunoassays. Both univariate analysis (Student t test, Welch test, chi(2) test, and Fisher exact test) and multivariate regression analysis (Cox analysis) were used. RESULTS: Increasing disturbance of the lactobacillary flora (lactobacillary grades I, IIa, IIb, and III) was highly correlated with the presence of Gardnerella vaginalis, Trichomonas vaginalis, enterococci, group B streptococci, and Escherichia coli. Vaginal pH and interleukin 8 and interleukin 1beta concentrations increased linearly with increasing lactobacillary grade, whereas lactate concentrations and the presence of epithelial cell lysis decreased. A similar pattern of associations with increasing leukocyte count was clear, but in addition there was an increase in leukemia inhibitory factor concentration. Multivariate analysis of vaginal leukocytosis, lactobacillary grades, and the presence of positive vaginal culture results showed that interleukin 1beta concentration was most closely related to the lactobacillary grade, leukemia inhibitory factor concentration was most closely related to the lactobacillary grade and positive culture results, interleukin 8 concentration was most closely related to positive culture results, and interleukin 1 receptor antagonist concentration was most closely related to vaginal leukocytosis and positive culture results. The concentration ratio of interleukin 1beta to interleukin 1 receptor antagonist remained stable, except when vaginal leukocytosis increased. In its most severe form, with >10 leukocytes per epithelial cell present, a decompensation of the vaginal flora with a collapse in interleukin 1beta and interleukin 1 receptor antagonist concentrations was seen, but there was a concurrent sharp increase in leukemia inhibitory factor concentration. This pattern was completely different from the course of the cytokine concentrations associated with a lactobacillary grade increase. CONCLUSION: Both disturbed lactobacillary grade and the presence of increasing vaginal leukocytosis were correlated with lactobacillary substrate (lactate) concentration, pH, and the concentrations of a variety of cytokines. There was a remarkably linear increase in these cytokines as either leukocytosis or lactobacillary grade became more severe. In circumstances in which leukocytosis was extreme, however, interleukin 1beta was no longer produced but leukemia inhibitory factor concentrations increased. We speculate that in extreme inflammation the body tries to limit the damage that can be done by exaggerated cytokine production.

Animals↗
PubMedDate not supplied

Leukocyte overshoot: a new sign of bioincompatibility in fast hemodialysis.

A high blood flow of 400 ml/min induces leukocytosis after 2 hr of dialysis with leukocyte concentrations of 110-150% of predialysis values. The leukocytosis occurs with both low and high biocompatible membranes, such as Cuprophan, Hemophan, and Polyamide. Cuprophan induces the most profound leukopenia, and also induces the most pronounced leukocytosis. For treatments with a given membrane there was, however, no correlation between leukopenia and leukocytosis. Leukopenia was independent of blood flow, while leukocytosis was strongly influenced by this factor. These observations indicate that different factors cause leukopenia and leukocytosis. Although a larger area induced more leukopenia, the effect was small. Membrane area had no effect on leukocytosis. There were no acute clinical side effects during dialysis that could be related to the leukocyte overshoot. The cause and chronic clinical consequences of leukocyte overshoot are unknown.

Adult↗
PubMed1990

Normal leukocyte counts in Staphylococcus aureus septicaemia.

Staphylococcus aureus septicaemia is still a serious disease with a high mortality. The absence of leukocytosis in serious bacterial infections is generally considered as an unfavourable prognostic sign. The leukocyte pattern in 75 patients with S. aureus septicaemia was reviewed retrospectively. In the 66 patients where leukocyte determinations were done within 2 days of positive blood culture, 21 presented without leukocytosis which contrasts to only 1/35 patients with Escherichia coli septicaemia studied as controls (p less than 0.001). During follow up of S. aureus septicaemia only 5 of the patients developed leukocytosis greater than 10 x 10(9)/l and 2 leukopenia. There was no significant difference in mortality in patients without initial leukocytosis (14%) compared to patients with initial leukocytosis (24%). Except for septic arthritis, which was associated significantly more often with leukocytosis, complications were found with about the same frequency in both groups. Thus absence of leukocytosis seems not be an unfavourable prognostic sign in S. aureus septicaemia.

Adult↗
PubMed1992

Increase in the rat blood leukocyte counts induced by PAF-acether is suppressed by general anesthesia.

Blood leukocyte count alterations induced by PAF-acether in anesthetized and nonanesthetized rats were investigated. Intravenous injection of increasing amounts of PAF-acether (1.5-8 micrograms/kg) in nonanesthetized animals induced dose-dependent hemoconcentration and leukocytosis. The former was apparent within 10 min, peaked from 30 min to 1 h, and diminished thereafter. The leukocytosis was noted within 30 min, was maximal at 1 h, and was over 4 h after injection of PAF-acether (4 micrograms/kg). It was characterized by a marked increase in the blood neutrophil counts under conditions in which the number of lymphocytes, monocytes, and eosinophils remained unchanged. PAF-acether-induced leukocytosis occurred in parallel with a marked decrease in the number of bone marrow nucleated cells, suggesting that the latter phenomenon may determine the former one. Leukocytosis by PAF-acether was inhibited dose-dependently by specific PAF-acether antagonists including BN 52021 (median effective dose ED50 = 4.99 mg/kg), WEB 2086 (ED50 = 4.59 mg/kg), and 48740 RP (ED50 = 9.02 mg/kg). General anesthesia by either pentobarbital, urethane, or ether inhalation, but not by ketamine, also impaired the PAF-acether-induced blood leukocytosis under conditions in which the hemoconcentration was not modified. In addition, pentobarbital-anesthetized rats did not have reduced bone marrow nucleated cell counts after PAF-acether stimulation. These findings are consistent with the assessment that PAF-acether-induced rat leukocytosis is accounted for by a bone marrow neutrophil mobilization process that is clearly suppressed in animals anesthetized by pentobarbital.

Anesthesia, General↗
PubMed2006

Can we define the ideal duration of antibiotic therapy?

BACKGROUND: Because of the increasing development of antimicrobial resistance, there is a greater responsibility within the medical community to limit the exposure of patients to antibiotics. We tested the hypothesis that shorter courses of antibiotics are associated with similar or better results than longer durations. We also sought to investigate the difference between a fixed duration of therapy and one based on physiologic measures such as fever and leukocytosis. METHODS: All infectious episodes on the general surgery units of the University of Virginia Health System from December 15, 1996, to July 31, 2003, were analyzed retrospectively for the relation between the duration of antibiotic therapy and infectious complications (recurrent infection with the same organism or at the same site). All infections associated with either fever or leukocytosis were categorized into quartiles on the basis of the absolute length of antibiotic administration or the duration of treatment following resolution of fever or leukocytosis. Multivariate logistic regression models were developed to estimate the independent risk of recurrence associated with a longer duration of antibiotic use. RESULTS: Of the 5,561 treated infections, 4,470 were associated with fever (temperature > or =38 degrees C) or leukocytosis (white blood cell count > or =11,000/mm(3)). For all infections, whether analyzed by absolute duration or time from resolution of leukocytosis or fever, the first or second quartiles (0-12 days, 0-9 days, 0-9 days, respectively) were associated with the lowest recurrence rates (14-18%, 17-23%, 18-19%, respectively). Individual analysis of intra-abdominal infections and pneumonia yielded similar results. The fixed-duration groups received fewer days of antibiotics on average, with outcomes similar to those in the physiologic parameters group. CONCLUSIONS: Shorter courses of antibiotics were associated with similar or fewer complications than prolonged therapy. In general, adopting a strategy of a fixed duration of therapy, rather than basing duration on resolution of fever or leukocytosis, appeared to yield similar outcomes with less antibiotic use.

Adult↗
PubMed2004

Squamous cell carcinoma of the cervix producing granulocyte colony-stimulating factor.

BACKGROUND: Marked leukocytosis is occasionally observed in patients with a malignant nonhematopoietic tumor. Granulocyte colony-stimulating factor (G-CSF) may be responsible for this phenomenon. We report a case of G-CSF-producing squamous cell carcinoma of the cervix that showed marked leukocytosis. CASE: A 71-year-old Japanese woman was admitted for further investigation for leukocytosis. Her white blood cell (WBC) count had been gradually increasing over a period of 10 months. Laboratory data on admission revealed marked leukocytosis, with a WBC count of 30,400/microL, which consisted primarily of mature granulocytes (93%). Her serum G-CSF level was significantly elevated. However, there was no evidence of infection or hematopoietic disorders. Further examinations showed stage IIIb cervical cancer. The pathological diagnosis was squamous cell carcinoma of the nonkeratinizing type. Immunohistochemical staining of the biopsied specimens confirmed the production of G-CSF protein by the tumor cells. The patient was successfully treated by radiation therapy. Her WBC count returned to a normal level (3,700/microL). Her serum G-CSF level also decreased. The patient is alive without evidence of recurrence at 8 months after the treatment. CONCLUSION: It is suggested that the leukocytosis manifested in this patient was due to G-CSF produced by the tumor. It was possible to use the WBC count and serum G-CSF levels as additional tumor markers.

Aged↗