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Background: This study aimed to assess the potential of serum interleukin-6 (IL-6) as a diagnostic marker in predicting bacteremia and to determine its association with severity and outcome among sepsis patients. Materials and methods: A prospective observational study was conducted, comprising a cohort of 118 patients admitted to the ICU with suspected sepsis from January 2019 to April 2020. Results: Among the 108 patients analyzed, 60 (55.6%) were bacteremic and 48 (44.4%) were nonbacteremic. Of 60 patients with bacteremia, 13 (21.6%) had sepsis and 47 (78.3%) had septic shock. In predicting bacteremia, the area under the curve (AUC) for IL-6 was 0.512 [95% CI, 0.400-0.623]. The AUC for IL-6 in differentiating sepsis from septic shock was 0.724 [95% CI, 0.625-0.823]. The sensitivity and specificity for predicting bacteremia for IL-6 were 66% and 67%, respectively (p < 0.001). Multivariate analysis revealed that C-reactive protein (CRP) (p = 0.04) and APACHE II score (p = 0.025) were significant predictors of bacteremia, whereas lactate (p = 0.04), and APACHE II score (p < 0.001) were significant predictors of sepsis severity. Patients with elevated levels of procalcitonin PCT (p = 0.024), APACHE II (p = 0.003), and SOFA (p = 0.002) scores had significantly higher mortality rates. Conclusion: C-reactive protein and APACHE II score, lactate and APACHE II score, and PCT, SOFA, and APACHE II scores performed better in predicting bacteremia, sepsis severity, and clinical outcome, respectively compared with IL-6. How to cite this article: Reddy PRV, Cherukuri M, Eshwara VK, Kudru CU, Prabhu RVK. Diagnostic Potential of Serum Interleukin-6 in Predicting Bacteremia in Adult Patients with Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2024;28(7):637-644.
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Cholinesterases belongs to class hydrolases. There are two types acetylcholinesterase and butyryl cholinesterase. Acetylcholinesterase present in nerve endings and also in the RBC membrane. It helps to maintain the shape and size of RBCs. Any change in shape and size of RBCs may affect the activity of Acetylcholinesterase. Thus this study aimed to estimate RBCs Acetylcholinesterase enzyme activity in various types of anemias and correlate the RBCs Acetylcholinesterase enzyme activity with various hematological indices such as Erythrocyte Sedimentation Rate (ESR), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Mean Corpuscular Volume (MCV), Red cell Distribution Width (RDW) etc. After obtaining ethical approval from Institutional ethics committee total of 100 samples were collected from Clinical Biochemistry laboratory, Kasturba Medical College, Manipal, Manipal University. 25 were having normal RBC indices, 12 with hemolytic anemia, 26 with microcytic anemia and 26 with macrocytic anemia based on peripheral smear report and RBC indices. Acetylcholinesterase were measured using Ellman's method. RBC acetylcholinesterase activity was significantly increased in microcytic anemia (58.13 ± 5.4) and macrocytic anemia (76.87 ± 6.7) than normal group (37.62 ± 2.71). Also increased RBC acetylcholinesterase was seen in hemolytic anemia (48.11 ± 5.18) but the increase is not statistically significant. RBC acetylcholinesterase correlated negatively with hemoglobin (r = -0.356, p = 0.001) and positively with RDW (r = 0.31, p = 0.003). To conclude RBC acetylcholinesterase activity can be used as one of the potential marker for various types of anemia.
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Talon cusp (TC) is a relatively uncommon developmental anomaly characterized by cusp-like projections from the cemento-enamel junction to a variable distance toward the incisal edge of an anterior tooth. It usually presents on palatal/lingual surface of the anterior teeth. Studies have revealed that it consists of enamel, dentine and a variable amount of pulp tissue. Presence of this cusp on the facial surface of an anterior tooth is a rare finding with very few cases being reported in the literature. The effects of TCs are mainly aesthetic and functional. The management requires a sufficient knowledge of the present clinical entity and the problems associated with it. Early detection and treatment plays a very vital role in avoiding the future complications. The present case reports a 25-year-old male patient with a facial TC on the mandibular left central incisor in which a prophylactic enameloplasty was carried out to avoid the stagnation of debris and stain.
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Behçet’s syndrome is a chronic multisystem vasculitis characterized by mucocutaneous, articular, neurological, gastrointestinal and ophthalmological lesions. Behcet’s syndrome is a disease of uncertain etiology. It may be due to immune dysregulation including circulating immune complex, autoimmune cytokines and heat shock proteins are major factor in the pathogenesis of Behcet’s syndrome. Patient’s positive pathergy test suggests a diagnosis of Behcet’s disease. Corticosteroids and immunosupressive drugs are the first line of treatment. This is a case report of juvenile Behcet’s syndrome in a thirteen year old girl associated with arthritis.
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Epulis fissuratum is a benign tumor like inflammatory hyperplastic growth which occurs on the mucosa along the borders of an ill fitting full or partial removable denture. If ulcerated, it can mimic oral squamous cell carcinoma. The treatment includes surgical removal of excess fibrous tissue and remodelling or reconstructing the denture suitably, ensuring better adaptability to the ridges. This case report describes a 55 year old male patient with characteristic clinical features of denture induced inflammatory hyperplasia.
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Cutaneous sins tract of dental origin are often misdiagnosed and inappropriately treated because of their uncommon occurrence and absence of symptoms in about half of the patients. A case report describing the diagnosis and treatment of an extra oral cutaneous sinus tract of odontogenic origin in relation to mandibular left first molar with surgical treatment and proper antibiotic coverage is presented.
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The mucocele is a salivary gland pathology that results from rupture of salivary gland duct and spillage of mucin into the surrounding tissues. The term mucous extravacation is also used to describe this lesion. The rupture of the gland or duct may be due to local trauma. The most common site of mucocele is lower lip. The treatment of mucocele includes cryosurgery , intra-lesional corticosteroid injection, micro-marsupialization, marsupialization of the mucocele, conventional surgical removal of the lesion , and laser ablation. The advantages of laser ablation over other methods include less treatment time, avoidance of suturing, minimal complications and relapse. Here we report a case of mucocele on lower lip treated using diode laser.
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Dentinogenesis imperfecta is an autosomal dominant disorder of tooth development characterized by the presence of opalescent dentine, resulting in a dusky blue to brownish discoloration of the teeth. It is the most common dental genetic disease. This condition is genetically and clinically heterogeneous, it may affect only the teeth or it may be associated with the osteogenesis imperfecta. Diagnosis is based on history, clinical examination and radiographic features. This report describes an 18 year old male patient who showed the characteristic dental features of dentinogenesis imperfecta.
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Fibromas are the benign tumours that are most commonly encountered among the oral soft tissue lesions. They are mostly seen as a protective mechanism of the mucosa towards chronic irritation. They present clinically as a round or ovoid, soft to firm in consistency, exophytic growth, mostly pale pink in colour with smooth surface. These lesions are asymptomatic and do not require any treatment until bothersome to the patient. The clinical features, histopathological features and treatment of an irritational fibroma occurring on the hard palate of a 32 year old female are presented.
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Osteoma is a benign slow growing osteogenic lesion, composed of well-differentiated mature bone tissue, characterized by the proliferation of compact or cancellous bone, almost exclusively found in the head and neck region. Central, peripheral and extra skeletal are the three variants of osteoma. Trauma, inflammation, developmental disorders and genetic defects are considered as the etiologic factors. Paranasal sinuses are the favourite locations of peripheral osteoma of the craniofacial region; frontal and ethmoidal sinuses being the common ones. Although, peripheral osteomas are usually benign, innocuous lesions, their size and prominent location on the visible parts of the face makes the surgical intervention necessary. We report case of multiple peripheral osteomas of forehead, without involvement of the frontal sinus, which is a rare variety.
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Eruption cyst (EC) is a benign cyst associated with a primary or permanent tooth in its soft tissue phase after erupting through the bone. It is most prevalent in the Caucasian race. It is clinically significant in that knowledge among general dentists is very essential regarding this developmental disturbance to reach the correct diagnosis and to provide proper treatment. We are reporting a case of eruption cyst in an 11 year old boy.
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Lichen planus (LP) is a chronic mucocutaneous disorder in which auto-cytotoxic T lymphocytes trigger apoptosis of epithelial cells leading to chronic inflammation. Oral Lichen Planus (OLP) is a disease which has a slight malignant potency. The diagnosis of OLP can be made from the clinical features if they are sufficiently characterized, but biopsy is recommended to confirm the diagnosis and to exclude dysplasia and malignancy. This is a case report of erosive lichen planus in a female patient, aged 45 years.
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Actinic lichen planus is a rare variant of lichen planus seen commonly in tropical and subtropical countries in the dark complexioned individuals. It manifests in the sun exposed areas of the face, neck and limbs. Though many cases have been reported in the skin, few lesions associated with the lip have been reported. The Lip is highly susceptible to actinic changes increasing the chances of malignancies. This is an unusual case report of 32 year old female patient where the lip lesion was seen mimicking discoid lupus erythematoses.