0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Bubonic Plague: Detection of Endotoxemia with the Limulus Test

THOMAS BUTLER, M.D.; JACK LEVIN, M.D., F.A.C.P.; DO QUANG CU, M.D.; and R. I. WALKER, Ph.D.
[+] Article and Author Information

Grant support: Bureau of Medicine and Surgery, Navy Department, Work Unit MRO41.20.01-0362A 2GI; NIH Training Grant No. AI-00009; and Research Grant HL-01601 from the National Heart and Lung Institute of the National Institutes of Health.

▸Requests for reprints should be addressed to Thomas Butler, M.D., Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD 21205.


Baltimore, Maryland, and Danang, Republic of Vietnam


Ann Intern Med. 1973;79(5):642-646. doi:10.7326/0003-4819-79-5-642
Text Size: A A A

Nine of 10 patients with fever and bubo were confirmed as having bubonic plague by isolation of Yersinia pestis from bubo aspirates or blood, or by serological responses. Common features were prostration, tachycardia, leukocytosis, thrombocytopenia, prolonged partial thromboplastin times, and abnormal liver function tests. Three patients were hypotensive, and one died. The limulus test detected endotoxemia in all nine confirmed cases at the time of admission. The limulus test was negative during convalescence in five of eight patients; three persistently positive cases had symptoms or laboratory findings suggesting continued effects of infection. Lyophilized bacteria from cultures of Y. pestis contained concentrations of endotoxin, as defined by the limulus test, similar to that in an equivalent mass of Escherichia coli. These data indicate further similarities between plague and other Gram-negative bacteremic infections and suggest that endotoxin may play a role in the acute symptoms of patients with plague.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)