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Capillary and venous leukocyte adhesiveness/aggregation to differentiate between viral and bacterial infection
R Rotstein1, M Kassirer, D Zeltser
1Dept. of Internal Medicine D, Tel Aviv, Sourasky Medical Center, 6 Weizman Str., 64239 Tel Aviv, Israel.
Background:
A simple capillary leukocyte adhesiveness/aggregation test (CAPLAAT) might be helpful in determining the intensity of inflammation in acute viral and bacterial infections.
Patients And Methods:
We included 30 patients with acute bacterial infections, 14 with viral infections as well as 48 healthy controls. The leukocyte adhesiveness/aggregation test (LAAT) test was performed using a simple slide test and image analysis.
Results:
The CAPLAAT had a similar discrimination power between bacterial and viral infections as both the white blood cell count (WBC) and the erythrocyte sedimentation rate (ESR). It was more sensitive than the WBC and the ESR (77%, 68% and 66%, respectively) for the detection of bacterial infections and had a comparable negative predictive value. By analyzing the size distribution of the aggregated leukocytes, we found that a venous leukocyte adhesiveness/aggregation test (VLAAT) of four cells and more had the best positive predictive value (94%) and specificity (95%) for diagnosis of an acute bacterial infection (from all the acute phase response variables examined).
Conclusion:
The CAPLAAT might be attractive for the detection of inflammation and for the assessment of its severity at points of care where the services of a clinical laboratory are not available around the clock.