• European cytokine network · Apr 2004

    High cytokine levels at admission are associated with fatal outcome in patients with necrotizing fasciitis.

    • Kathrin Lungstras-Bufler, Philip Bufler, Rabiatu Abdullah, Christine Rutherford, Stefan Endres, Edward Abraham, Charles A Dinarello, and Robert M Rodriguez.
    • University of Colorado, Health Sciences Center, Denver, CO 80262, USA. lungstras@gmx.de
    • Eur. Cytokine Netw. 2004 Apr 1;15(2):135-8.

    AbstractWe 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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