الفهرس 
Introduction and aim of work
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Abstract
Introduction: Sepsis and its complications are major causes for morbidity and mortality. Despite the recent advances in the medical practice, the mortality rate among septic patients still ranges from 30% to 50%. Early diagnosis of sepsis offers the best outcome. The routine laboratory tests for sepsis lack both sensitivity and specificity and most confirmatory tests have delayed results. IL18 is a newly discovered proinflammatory cytokine. It belongs to IL1 cytokine family. It has multiple biological functions, including the induction of other cytokines and regulation of host defense against infection. Aim of work: The present study was designed to evaluate the value of IL18 as an early marker of septicemia in surgical patients. Patients and methods: A total of 47 patients were selected from surgical departments in Emergency Hospital and from Mansura University Hospital. In addition ten healthy subjects, with matched age and sex, were selected as control. Studied cases were classified according to their clinical presentations into: Group 1: Included 27 patients presented with surgical diseases and evidence of septicemia. Group 2: Included 10 patients presented with surgical disease with local infection, and without evidence of septicemia. Group 3: Included 10 patients presented with surgical disease without evidence of septicemia. Group 4: Included 10 healthy subjects as control group. Results: Isolated organisms from blood cultures were Staph. aureus (85.2% of total) and E.coli (14.8%). TLC is poorly specific test for sepsis, as it can be elevated in both septicemic patient and patient with other types of infections. CRP failed to differentiate between septicemic patients and others, because it is an acute phase protein that increases in any tissue damage. IL18 could effectively differentiate between septicemic and non septicemic patients. Conclusions: from this study; it seems that interleukin18 is a sensitive, specific, accurate and rapid marker for diagnosis of surgical septicemia.