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We evaluated 50 consecutive patients with acute ischemic stroke to assess the prevalence of systemic infection preceding the neurological event.We analyzed the immunohematologic characteristics of patients with and without signs and/or symptoms of a preceding infectious process.Patients were examined=7 days after cerebral infarction and evaluated for fibrinogen,anticardiolipin antibodies,fibrin D-dimer(a fragment of cross- linked fibrin),plasminogen activator inhibitor-1,and protein S.Of the 50 patients,17 had symptoms of infection beginning=1 month before the stroke(11 had upper respiratory tract infections,three urinary tract infections,two subacute bacterial endocarditis,and one pneumonia).Compared with patients without infection,patients with infection had significant increases in fibrin D-dimer concentration(5.3+/-1.1 versus 4.7+/-0.9 log- transformed ng/ml,p<0.05)and cardiolipin immunoreactivity,IgG isotype(1. 8+/-1.3 versus 1.1+/-0.9 log-transformed phospholipid units,p<0.04),and, when studied=2 days after the stroke,increased fibrinogen levels(459+/- 126 versus 360+/-94mg/dl,p<0.05).In conclusion,infection-associated cerebral infarction is common and is associated with substantial immunohematologic abnormalities. |
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