CONSTITUENT ANALYSIS MAY PERMIT IMPROVED DIAGNOSIS OF INTRA ABDOMINALABSCESS

BACKGROUND: Intra-abdominal abscesses (IAA) often fail to resolve with intravenous antibiotics alone and frequently require drainage. Diagno sis of IAA in postoperative patients with other likely sources of infe ction is very difficult.PATIENTS AND METHODS: In order to characterize IAA and identify parameters that might facilitate diagnosis, we prosp ectively examined peripheral blood and pus of 15 consecutive patients with IAA and compared them to samples from 34 consecutive patients wit h soft-tissue abscesses (STA). RESULTS: Serum interleukin (IL)-10 was elevated in IAA patients, while abnormally detectable serum IL-4 was d emonstrated in the pus of both IAA and STA patients. IL-10 in IAA pus was more than 11-fold higher than in STA, whereas IL-4 in pus was simi lar in both types of abscesses, Both IL-4 and IL-10 were 4- to 10-fold higher in IAA and STA pus than in corresponding patient serum. Serum lysozyme was, however, significantly elevated in all ab- scess patient s. CONCLUSIONS: The presence of IL-4 and IL-10 may indicate a T-helper 2 lymphocyte response in the etiology of abscess formation and persis tence, although precise determination of T-helper 1-related cytokines is needed to verify this, Serum lysozyme and IL-10 may be reliable and relatively inexpensive diagnostic aids.