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The Limulus Test and Gram-Negative Bacillary Sepsis-Reply

Am J Dis Child. 1975;129(5):644. doi:10.1001/archpedi.1975.02120420076024.
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Sir.—We agree that the Limulus assay is suitable for detecting endotoxemia, but contend that it is not of value in detecting Gram-negative bacillary sepsis or bacteremia. Only when the preparation and sensitivity of Limulus lysate and extraction procedure of endotoxin have been standardized can the clinical usefulness of this test be finally determined. Ultimately the physician will have to ask, "Will this test assist me in determining the diagnosis and management of my patient's condition?" If the number of false positives and false negatives is equal to or greater than the number of true positives or true negatives (based on culture-proved infections), then the test will offer no advantage over the present clinical and laboratory diagnosis of infection, and may indeed be another cost-accountable expense for the patient. To date, the published studies are only suggestive of clinical value of the assay. Further studies in large and high-risk populations


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