DIAGNOSTIC AND PROGNOSTIC-SIGNIFICANCE OF PLASMA ENDOTOXIN DETERMINATION IN FEBRILE PATIENTS WITH HEMATOLOGICAL MALIGNANCIES

We evaluated the clinical utility of a new endotoxin-specific chromoge nic limulus test in febrile patients with haematological malignancies. The specificity is assured by the removal of factor G, which is sensi tive to (1-->3)-beta-D-glucan, from horseshoe crab amoebocyte lysate. The sensitivity and specificity of the test to systemic gramnegative b acterial infections were 69.7 and 96.3%, respectively. Meanwhile, gram -negative bacteria grew in only 39.7% of endotoxaemic samples. Thus, i t seems appropriate to consider gram-negative bacteraemia and endotoxa emia as different entities. Endotoxaemia was significantly associated with septic shock and infectious death, especially in patients with ne utropenia, The new test, the results of which are available within 3 h , should help physicians to recognise this ominous sign early and to i nitiate a prompt countermeasure to endotoxaemia.