Plasma Endotoxin as a Predictor of Multiple Organ Failure and Death in Systemic Meningococcal Disease

We studied prospectively the quantitative relation of circulating endotoxin (lipooligosaccharides [LOSs)) and the development of multiple organ failure and death in 45 consecutively admitted patients with bacteriologically verified systemic meningococcal disease (SMD). A plasma illS level of >700...

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Bibliographic Details
Published in:The Journal of infectious diseases 1989-02, Vol.159 (2), p.195-204
Main Authors: Brandtzaeg, Petter, Kierulf, Peter, Gaustad, Peter, Skulberg, Andreas, Bruun, Johan N., Halvorsen, Sverre, Sørensen, Eigil
Format: Article
Language:English
Subjects:
Adolescent
Adult respiratory distress syndrome
Antibiotics
Bacterial diseases
Bacterial diseases of the nervous system. Bacterial myositis
Biological and medical sciences
Blood
Blood plasma
Child
Child, Preschool
Endotoxins
Endotoxins - blood
Female
Human bacterial diseases
Humans
Infant
Infectious diseases
Lipopolysaccharides - blood
Male
Medical sciences
Meningitis, Meningococcal - blood
Meningitis, Meningococcal - complications
Meningitis, Meningococcal - mortality
Meningococcal meningitis
Multiple organ failure
Multiple Organ Failure - physiopathology
Neisseria meningitidis
Neisseria meningitidis - isolation & purification
Original Articles
Pathology
Prognosis
Sepsis
Septic shock
Shock, Septic - blood
Shock, Septic - complications
Shock, Septic - mortality
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Summary:We studied prospectively the quantitative relation of circulating endotoxin (lipooligosaccharides [LOSs)) and the development of multiple organ failure and death in 45 consecutively admitted patients with bacteriologically verified systemic meningococcal disease (SMD). A plasma illS level of >700 ng/L correlated with development of severe septic shock (P .0001), adult respiratory distress syndrome (P = .(035), a pathologically elevated serum creatinine level (P < .0001), or death as a consequence of multiple organ failure (P = .0002). Initial plasma illS levels of 10 000 ng/L were associated with 0%, 14%, 27%, and 86% fatality, respectively. The illS half-life after initiation of antibiotic therapy was 1–3 h. Increasing plasma LOS levels were never seen. These observations suggest that LOS quantitation using the limulus amebocyte lysate assay with a chromogenic substrate gives important progsnotic information and may provide new insight concerning pathophysiological aspects of SMD.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/159.2.195