Studies in Staphylococcal Fever

Despite intensive investigation of the fever caused by endotoxins of Gramnegative bacteria, the pyrogenic properties of Gram-positive bacteria appear to have attracted relatively little attention. There are scattered reports dealing with fever-inducing effects of whole cultures or culture filtrates of several Gram-positive organisms given intravenously.`6 Other investigators, however, have been unable to confirm this in the absence of infection7'8 and in those cases where fever has been obtained, no systematic attempt has been made to determine whether the pyrogenic constituent resides in a cellular component, the culture medium, or both. Only with Group A streptococci has there been recent study of the pyrogens present and, in most instances, these findings do not appear applicable to other Gram-positive organisms.9` Gram-positive bacterial infections are among the most pyrogenic diseases in man. Since these microorganisms mobilize an exudate rich in polymorphonuclear leukocytes which contain an endogenous pyrogen (EP), fever has been attributed to pyrogenic substances released by host cells at extravascular sites of infection.8 In confirmation of this concept, substances with properties of leukocytic pyrogen have been isolated at foci of inflammation and in the blood stream following subcutaneous and intraperitoneal infection of rabbits with Group A streptococci and pneumococci, respectively.' On the other hand, there has been conflicting evidence to show that Gram-positive bacteria are capable of causing fever prior to establishment of an infection since, with the possible exception of Group A hemolytic