Host-defence mechanisms in surgical patients: case report of reduced polymorphonuclear neutrophil and antibody functions associated with surgical sepsis.

The authors evaluated the host-defence capability of a 33-year-old woman with a history of poor wound healing, gastrointestinal fistulas and bacterial and fungal sepsis after abdominal operations. The following tests gave normal results: hemoglobin, blood neutrophil and monocyte counts, delayed hypersensitivity skin test, serum albumin, immunoglobulin and complement levels, blood T- and B-cell percentages, in-vitro immunoglobulin synthesis and body cell mass. The following tests gave abnormal results: lymphocyte count, leukocyte adherence, in-vivo and in-vitro polymorphonuclear neutrophil chemotaxis, neutrophil bacterial killing and antibody response to tetanus toxoid. Decreased polymorphonuclear neutrophil and humoral immune functions could account for the woman's history of repeated surgical sepsis. Evaluation of host-defence mechanisms can illuminate the cause of repeated episodes of sepsis.