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Shock Caused by Gram-negative Microorganisms: Analysis of 169 Cases

Ann Intern Med. 1964;60(3):384-400. doi:10.7326/0003-4819-60-3-384
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A syndrome that is characterized by acute hypotension and shock and occurs during the course of bacteremia due to gram-negative microorganisms was described in 1951 (1, 2). Since then there has been an increasing interest in this entity and in experimental models in which shock is produced in laboratory animals by injection of endotoxin derived from gram-negative bacteria. Initially regarded as a relatively rare occurrence, reports of more than 200 cases in the past decade indicate that this is a common complication in both medical and surgical patients (3-11).

In 1958, Spink and one of the present authors (5) reported


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