A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardio-vascular shock, and subsequent death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause?
a. Gram-positive bacteria
b. Fungi
c. Gram-negative bacteria
d. Virus
ANS: C
Symptoms of gram-negative septic shock are produced by endotoxins. Once in the blood, endo-toxins cause the release of vasoactive peptides and cytokines that affect blood vessels, producing vasodilation, which reduces blood pressure, causes decreased oxygen delivery, and produces subsequent cardiovascular shock. Gram-positive bacteria nor fungi do not produce endotoxins and thus do not manifest in shock. Viruses do not produce symptoms of shock.
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