An 80-year-old woman presents with a 4-hour history of fever, shaking chills, and disorientation. Her blood pressure is 80/40 mm Hg. Physical examination shows diffuse purpura on her upper arms and chest. Blood cultures are positive for Gram-negative organism. Which of the following cytokines is primarily involved in the pathogenesis of direct vascular injury in this patient with septic shock?
Septicemia (bacteremia) denotes the clinical condition in which bacteria are found in the circulation. It can be suspected clinically, but the final diagnosis is made by culturing the organisms from the blood. In patients with endotoxic shock, lipopolysaccharide released from Gram-negative bacteria stimulates monocytes/macrophages to secrete large quantities of TNF-a.
Interferon-g
Transforming Growth Factor-b (TGFb)
Platelet-derived growth factor
Tumor necrosis factor-a
Chemical mediators in plasma: Kinin system