The Nitroblue Tetrazolium Reduction Test versus Conventional Hematology in the Diagnosis of Bacterial Infection

Abstract

Two hundred and eighty-nine patients were prospectively evaluated to determine the value of the nitroblue tetrazolium test as compared to five routine hematologic procedures in diagnosing bacterial infection. Of 529 samples of blood taken for culture, 26 documented bacteremia, and two fungemia. In half the samples showing bacteremia the test was positive (score of ≥ 10), whereas in more than half, the white-cell count was elevated, the differential count revealed increased numbers of immature granulocytes, and toxic granulations were present. In patients with documented bloodstream invasion Döhle bodies and vacuolization were present in 29 per cent. A single hematologic abnormality was present in 93 per cent, and two or more in 79 per cent of the patients with septicemia. The use of conventional hematologic procedures appears to be more sensitive than the nitroblue tetrazolium test in detection of bacterial infection. (N Engl J Med 290:235–238, 1974)