Limulus amebocyte lysate test for endotoxemia

The question of specificity of Limulus amebocyte lysate (LAL) test in the diagnosis of endotoxemia has been a limiting factor of its clinical application. Using a femtogram-sensitive spectrophotometric LAL assay 35 of 36 septic postoperative patients showed an excellent correlation (almost 100%) between positive LAL tests and culture-proven gramnegative bacteremia. Twenty patients of this group demonstrated a significant correlation (2p<0.05) between elevated total white blood cell counts and Escherichia coli Endotoxin equivalents (EcEe).