Abstract
During and after the war, many clinicians in Japan witnessed unexpected febrile reactions following intravenous injections of the oficinal products of glucose-solution in ampuls which were apparently made to conform to the pharmacopoeia requirements. Main purpose of our present investigations is to contribute to solve this common problem in the postwar time. So far as the pharmacopoeial products of glucose-powder are concerned, the important rôle of pyrogens as a cause of clinical pyrexia cannot be ignored, as shown in the conclusion of our previous report (1). We have no doubt of the fact that certain moulds and yeasts as well as bacteria existing in glucose-powders are capable to produce pyrogens under a suitable humidity and temperature, and presumably even in a “dry” state of the powders. In the experiments regarding glucose-powder, as shown in the previous report, pyrogens were accompanied generally with pyrogen-producing microbes in experimental materials, and then they could be easily separated from microbes in case of necessity. Now, in the present attempt to determine the pyrogenecity of glucose-solution in ampuls, we must dear with a rather more involved matter, since all the samples to be adopted here are free from any mycologically or bacteriologically positive evidence as to the possible presence of microbes in them.
The mode of clinical occurrences of febrile reactions following glucose injections seemed to be sporadic, so far as the commercial solutions sealed in ampuls are concerned. It was sometimes reported that when an ampul packed in a box proved pyrogenetic to a patient, some of the rest of the ampuls packed with it in the same box did not always yield a similar reaction to other patients. Aside from pyrogenetic microbes, we have to determine whether or not pyrogens are common in all ampuls of the same lot-number. Supposing the amount of pyrogens contained to be small, susceptibilities of the patient would play an important part to exhibit an equivocal phenomena concerning febrile reactions in clinics. This is also one of the questions to be solved in our experimental investigations.
