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Previous Volume 340:1122 April 8, 1999 Number 14 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: A succession of at least 57 moderate-to-severe endotoxin-like reactions has occurred in the western United States over an approximately six-month period. These reactions were associated with the administration of endotoxin-contaminated gentamicin for injection manufactured by Fujisawa USA.¹

Endotoxin (a lipopolysaccharide) is a component of the cell wall of gram-negative bacteria and mediates many of the clinical features observed in gram-negative bacterial sepsis. These include fever, shaking chills, and cardiovascular symptoms, and in more severe cases include muscle proteolysis, uncontrolled intravascular coagulation, shock, and death. Endotoxin stimulates mononuclear cells to produce interleukin-1, tumor necrosis factor , and possibly . . . [Full Text of this Article]

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