Comparison of antibody response with delayed hypersensitivity in severely injured patients

Archives of Surgery
M J HershmanH C Polk

Abstract

Twenty-seven severely injured patients had antibody response to gram-negative organisms measured of whom 25 also had skin testing. Twenty-three patients (92%) were anergic at admission. Injury Severity Scores were greater in patients who remained anergic for three weeks compared with patients whose skin tests became positive. Patients with major infection had longer anergy duration than uninfected patients. Twenty-two (81%) of 27 anergic patients mounted antibody responses. Initial bacterial contamination determined the clinical outcome and antibody response. Six of eight patients with moderate contamination mounted IgM responses to all organisms and/or an IgG response to Escherichia coli, and they remained uninfected. Of the other two patients, one died, and the other developed chronic infection. Seven of eight patients with heavy contamination developed major sepsis despite mounting several antibody responses. Six patients without contamination mounted no antibody responses and remained uninfected.

Citations

Sep 1, 1993·Veterinary Immunology and Immunopathology·C M OttoD L Dawe
Dec 1, 1989·American Journal of Surgery·L J CurtsingerH C Polk
Aug 1, 1990·Burns : Journal of the International Society for Burn Injuries·H J BelcherP Riches
Dec 1, 1994·The British Journal of Surgery·H J NielsenH Nielsen
Dec 6, 2001·Experimental and Molecular Pathology·G K YadavalliF P Heinzel
Jan 8, 2000·The Surgical Clinics of North America·R P Rabinowitz, E S Caplan
Feb 1, 1997·Current Problems in Surgery·H C PolkW G Cheadle
Apr 25, 2008·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·I Leonard BernsteinUNKNOWN American College of Allergy, Asthma and Immunology

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