October 1978

Endotoxemia in Typhoid Fever

Author Affiliations

Pavia, Italy

Bari, Italy

Arch Intern Med. 1978;138(10):1579. doi:10.1001/archinte.1978.03630350099028

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To the Editor.—  Dr Thomas Butler et al presented quite interesting data on the behavior of blood coagulation, bacteremia, and endotoxemia in typhoid fever in the March 1978 Archives (138:407-410). We fully agree with them on many of the conclusions they reach, particularly the low number of bacteria invading the blood stream, but we wish to comment on the rather unexpected report of negative limulus tests in all of their patients, a finding contrasting partially with our previous observation of a positive assay in nine out of 14 cases.1While we can agree with Butler et al in explaining this discrepancy on the basis of a different method of extraction of plasma, we find rather incautious the statement that in our studies contamination of samples might have occurred. In effect, our tests were concomitantly performed on samples of plasma obtained during the illness and in the convalescent period and

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