Data on the results of N.B.T. (nitroblue tetrazolium) dye tests which were performed upon blood obtained from 82 patients during the course of admission at the department of surgery
Of Seoul National University from December, 1974 to. March, 1975 are presented and the literature is reviewed.
The mean proportion of N.B.T.positive neutrophils was 9.6±5.3% (mean±SD) in patients with non-bacterial illness, 32.4±12.43% in patients with bacterial illnesses and 3.2±1.56% in patients with hyperbilirubinemia.
In icteric patients N.B.T. score had a tendency to decrease in proportion to the level of serum bilirubin and the regression equation of N.B.T. score against the level of serum bilirubin was as follows.
N.B.T. score (%)=4.55-0.095X Serum bilirubin(mg/dl) (r= -0.43)
In uncomplicated cases with clean wound after operation, transitory increase in N.B.T. positive neutrophils was on the first post-operative day. In uncomplicated cases with clean-contaminated wound or contaminated wound the peak score was on the first three days; thereafter the level declined. On the other hand the score remained elevated and had persistently positive tests in complicated cases even if there was no evidence of bacteremia.
In patients with typhoid fever the N.B.T. score was not elevated.
The N.B.T. score was raised even in patients under long-term Imuran and prednisone therapy after kidney transplantation when they had complication such as pneumonia.
Even if the simple N.B.T. test does not always indicate the presence of bacterial illness, N. B.T. test proves to be useful adjunct as a means of supporting the diagnosis of various clinical conditions when the test is supplemented by the history, clinical symptoms and signs, physical
findings, white blood cell count with differential count and culture with the examination of the peripheral blood smear for the presence of toxic granulation, Dohle bodies and vacuolation in the neutrophils of patients under evaluation.
We expect that N.B.T. dye reduction test will provide possible good information for the early detection of various post-operative complications such as wound abscess, atelectasis, evisceration, pelvic abscess, intraperitoneal leakage of contents of viscera and sepsis and for the prediction of further prognosis with the comparison of the routine N.B.T. score on the 4 th and 7th days
after every operation.
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