Plasma levels of tumor necrosis factor-alpha and interferon-gamma in Sicilian children with Mediterranean spotted fever.

The plasma levels of tumor necrosis factor-alpha and interferon-gamma were measured in 53 consecutive children with serologically confirmed Mediterranean spotted fever and were found to be increased during the acute phase compared with the convalescent phase (tumor necrosis factor-alpha mean 32.17 vs. 4.12 pg/ml, P < 0.0001; interferon-gamma mean 84.17 vs. 2.65 pg/ml, P = 0.0006). Plasma levels of both cytokines were higher in patients with a typical exanthema rather than those with a very mild or no exanthema; tumor necrosis factor-alpha levels were significantly lower in the latter (tumor necrosis factor-alpha 32.17 vs. 9.85 pg/ml, P < 0.0001; interferon-gamma 84.17 vs. 38.14 pg/ml, P = 0.35). Tumor necrosis factor-alpha and interferon-gamma may be harmful or beneficial to the infected host, depending upon the amounts produced and whether they are circulating or confined locally to the site of inflammation.