Background. Lymphocytes play an important role in the activation of po
lymorphonuclear neutrophil (PMN) antimicrobial functions. This study w
as undertaken to evaluate the ability of lymphocytes from severely inj
ured adults with elevated Candida antigen liters to activate the antic
andidal function of normal PMNs.Methods. Lymphocytes from 13 injured a
dults with elevated Candida antigen titers (titer+) were isolated and
incubated with or without heat-killed C. albicans. After a 48-hour inc
ubation, cell culture supernatants were harvested and tested for the a
bility to activate the anticandidal function of normal PMNs. Lymphocyt
es from 13 volunteers and 13 injury-matched patients with negative Can
dida antigen titers (titer-) were studied for comparison. Results. The
patients with titer+ and titer- were well matched in terms of age, se
x, Injury Severity Score, units of blood transfused, and length-breadt
h of antibiotic therapy. Patients with titer+ had a higher incidence o
f bacterial infections than did patients with titer-. Only 2 of the 13
patients with titer+ had a positive Candida culture. Lymphocytes from
the volunteers and patients with titer- released large amounts of a P
MN-activating factor(s) when exposed to C. albicans. Lymphocytes from
the patients with titer+ were defective in their ability to release th
is activating factor(s) after exposure to C. albicans. Conclusions. Al
though culture evidence of Candida as uncommon, injured adults with el
evated Candida antigen titers have lymphocyte dysfunction and often su
ffer documented bacterial infections.