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September 1965

Shock Associated With Bacteremia Due to Gram-Negative Bacilli: Autopsy Findings

Author Affiliations


From the Infectious Disease Control Unit, Department of Medicine, Marquette University School of Medicine and Milwaukee County General Hospital. Associate Clinical Professor of Medicine, Marquette University (Dr. Waisbren) and Resident in Medicine, Veterans Administration Hospital, Los Angeles (Dr. Arena).

Arch Intern Med. 1965;116(3):336-339. doi:10.1001/archinte.1965.03870030016004

THE SYNDROME of extreme hypotension, prostration with mental alertness, bluish pallor, and quiet death first was described as being associated with bacteremia due to gram-negative bacilli in 1951.1 The pathologic physiology of this syndrome remains unknown in spite of the many reports that have been published regarding it since 1951.2-5 In this study autopsies of patients who died with the classic clinical and laboratory findings of shock associated with bacteremia due to gram-negative bacteria were reviewed to determine if they would reveal any information that would help delineate pathogenesis.

In addition, the findings in these human autopsies were compared with those reported in dogs injected with a lethal dose of endotoxin to try to find evidence for the commonly made assumption that gram-negative shock in humans is similar to endotoxin shock in dogs.5-12

Materials and Methods  The hospital records of 230 patients with blood cultures positive for