We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

The Shock Syndrome Associated with Bacteremia Due to Gram-Negative Bacilli

AMA Arch Intern Med. 1958;101(2):184-193. doi:10.1001/archinte.1958.00260140016004.
Text Size: A A A
Published online


Antibiotics have caused remarkable changes in the incidence and management of infectious diseases. Infections due to Gram-positive organisms, notably those caused by pneumococci and streptococci, have diminished in incidence and in severity. On the other hand, this decline has been paralleled by a decided increase both in the frequency and in the severity of disease caused by Gram-negative bacteria, including the coliform group.1-9

This changing pattern has been attributed to at least two factors. First, the Gram-positive bacteria are effectively suppressed by chemotherapeutic agents. Secondly, there has been the emergence of an increasingly larger proportion of Gram-negative micro-organisms that are highly resistant to the action of available antibiotics.1-4 Studies in individual patients have shown that the relatively nonpathogenic strains of bacteria, such as Escherichia coli, Proteus vulgaris, Aerobacter aerogenes, or Pseudomonas aeruginosa, may actually invade and cause infection during the course of antibiotic treatment.5-9 This paradox has


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

141 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.