PLASMA CYTOKINES IN PEDIATRIC TYPHOIDAL SALMONELLOSIS - CORRELATION WITH CLINICAL COURSE AND OUTCOME

We evaluated the clinical profile, outcome and serial plasma interleuk in 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) concentrations in 38 consecutive children (aged 6 months-14 years) admitted with cul ture-proven multidrug resistant typhoid, All children received therapy for 14 days with either i.v. ceftriaxone or oral cefixime, with compa rable outcome. Concentrations of IL-6 and TNF-alpha were significantly elevated in over 50% of the cases and correlated with clinical severi ty of illness as quantitated by the typhoid morbidity score, Sequentia l measurements revealed a significant decrease in IL-6 and TNF-alpha c oncentrations within 7 days of initiation of therapy (P<0.05), While n o clear relationship was seen with time-to-defervescence, the failure rate was significantly higher in children with baseline serum IL-6 val ues >400 pg/ml (P<0.05). Our data suggest that plasma cytokine activit y is frequently elevated in children with typhoidal salmonellosis, and IL-6 concentrations show a correlation with clinical severity and rec overy from the illness.