Pyrogenic reactions in patients undergoing cardiac catheterization associated with contaminated glass medicine cups

Susan Temporado Cookson, James J. Nora, Joseph A. Kithas, Matthew J. Arduino, Walter W. Bond, Phyllis H. Miller, Jan Monahan, Richard E. Hoffman, Tyler Curiel, Dimitri Kaufman, Bertron M. Groves, William R. Jarvis

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Pyrogenic reactions are potentially life-threatening complications caused by bacterial endotoxin. After two cardiac catheterization patients developed rigors the same day, the procedures were halted and a case control study was conducted. To identify case patients (persons with rigors ≤3 hr after catheterization during September 25-November 9, 1995), we reviewed medical records of all cardiac catheterization patients who had a blood culture or received intravenous meperidine. Twelve case patients and 40 randomly selected control patients were identified. No specific catheter was associated with case patients, but exposure to intracoronary-nitroglycerin (NTG) was (odds ratio = 12.0; 95% confidence interval 2.2, 75.6). NTG or indocyanine green dye was poured into glass medicine cups previously washed in an enzyme cleaner and then sterilized. The cleaner, used for an entire day, had elevated levels of gram-negative bacteria (> 104 colony forming units/mL) and endotoxin (434 endotoxin units [EU]/mL]); the reprocessed cups had no live bacteria but had elevated endotoxin levels (median 2,250 Eu). Exposure to contaminated glass medicine cups probably resulted in pyrogenic reactions and contributed to death in two critically ill patients.

Original languageEnglish (US)
Pages (from-to)12-18
Number of pages7
JournalCatheterization and Cardiovascular Diagnosis
Issue number1
StatePublished - Sep 1997
Externally publishedYes


  • Endotoxin
  • Fever
  • Pyrogenic reaction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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