Clinical Recognition and Treatment of Endotoxinemia

  • Joseph G. Sinkovics
Part of the University of South Florida International Biomedical Symposia Series book series (EMISS, volume 18)


In health we co-exist with our bowel flora without harm from lipopoly-saccharide endotoxins that the gram-negative constituents of this flora produce and release. The lower intestinal tract of patients entering hospitals becomes rapidly colonized by the nosocomial gram-negative flora dominant in that environment. Green salads, faucets, the vase holding cut flowers at the bedside serve as common sources of colonization without tissue invasion. Breaking through natural barriers (indwelling arterial and venous lines, genitourinary and other catheters, mucosal ulcerations of the oral cavity and gastrointestinal tract), leukopenia (including granulocyto- and lymphocytopenia and depletion of monocytes-macrophages) allow for invasion of tissues and blood stream by gut flora containing also the colonizing nosocomial bacteria (Pseudomonas sp., Serratia sp.). Absorption of endotoxin from the compromised gastrointestinal or genitourinary tracts may occur without actual bacterial invasion of the blood stream. Gram-negative bacteria invading soft tissues and blood produce and release endotoxins. These endotoxins exert diverse and most profound biological effects often cascading relentlessly toward irreversible shock and death.


Septic Shock Central Venous Pressure Endotoxin Shock Plasma Protein Fraction Corynebacterium Parvum 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Plenum Press, New York 1986

Authors and Affiliations

  • Joseph G. Sinkovics
    • 1
    • 2
  1. 1.Community Cancer CenterSt, Joseph’s Hospital and University of South Florida College of MedicineTampaUSA
  2. 2.Department of Virology and EpidemiologyBaylor College of MedicineHoustonUSA

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