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Pyrogenic Reactions After Inadvertent Infusion of Endotoxin During Cardiac Catheterizations

M. P. REYES, M.D.; S. GANGULY, M.D.; M. FOWLER, M.D.; W. J. BROWN, Ph.D.; B. G. GATMAITAN, M.D.; C. FRIEDMAN, M.P.H.; and A. M. LERNER, M.D.
[+] Article and Author Information

This paper was presented in part at the Annual Meeting of the Michigan Chapter of the American College of Physicians, Gaylord, Michigan, 6-8 October 1978.

▸Requests for reprints should be addressed to Milagros P. Reyes, M.D.; Hutzel Hospital, 4707 St. Antoine Boulevard; Detroit, MI 48201.


Detroit and Allen Park, Michigan


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;93(1_Part_1):32-35. doi:10.7326/0003-4819-93-1-32
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In April 1976 the attack rate of chills and fever with or without falls in blood pressure increased in association with cardiac catheterizations. Fevers were associated with coronary angiography and right and left heart catheterizations. Blood cultures were negative, and reactions did not correlate with amounts of contrast materials infused or with procedures done by a single operator. Significant numbers of Acinetobacter calcoaceticus (var. anitratus) and a Pseudomonas species were cultured from hospital-reservoir distilled water when it was flushed through a catheter before gas sterilization. This same water after ethylene oxide sterilization contained 2 X 105 ng/mL of endotoxin by limulus lysate test and was positive by rabbit pyrogen test. When washed reusable cardiac catheters were sterilized daily or when disposable catheters were substituted, febrile reactions ended. Pyrogenic reactions in patients undergoing cardiac catheterizations corrrelated with emptying retained endotoxin with injected contrast material from reused washed-sterilized catheters.

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