Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
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Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
════════╤═════════════════╤═════════════════
│ │
│ STAPHYLOCOCCI │ B. INFLUENZÆ
────────┼────────┬────────┼────────┬────────
│ NO. │PER CENT│ NO. │PER CENT
│POSITIVE│POSITIVE│POSITIVE│POSITIVE
────────┼────────┼────────┼────────┼────────
Bronchus│ 61│ 50.4│ 96│ 79.3
Lung │ 37│ 24.2│ 70│ 45.7
Blood │ 1│ 0.5│ 1│ 0.5
────────┴────────┴────────┴────────┴────────
Cultures from the bronchus represent the bacteriology of the bronchitis
of influenza. Infection of the lung following influenza doubtless occurs
by way of the bronchi, so that the bacteria which cause pneumonia are
present in the bronchi before they enter the lung tissue. The figures in
Table XXVIII, similar to those previously cited, show the high incidence
of B. influenzæ, and the occurrence of pneumococci, hemolytic
streptococci and staphylococci each present in approximately half of all
autopsies.
The figures in Table XXVIII are an index of the capacity of the
microorganisms which enter the bronchi to invade the lungs and finally
the blood. Pneumococci were present in the bronchi in 46.3 per cent of
instances, in the lungs in only slightly less, and in approximately 40
per cent of autopsies they had penetrated into the blood. Hemolytic
streptococci enter the bronchi with the same frequency and exhibit an
equal ability to penetrate into the lungs and blood. Staphylococci enter
the bronchi in half of these individuals, but penetrate into the lungs
in only a fourth of the instances. They have entered the blood only once
(Autopsy 263) in this instance in association with hemolytic
streptococci. B. influenzæ has been present in the bronchi in
approximately 80 per cent of autopsies. It is noteworthy that it has
been found in the lung in little more than half this percentage of
instances and has entered the blood only once (Autopsy 474), in this
instance in association with hemolytic streptococci.
In a limited number of autopsies there was purulent bronchitis
recognized by the presence of mucopurulent exudate in small bronchi. It
has been stated that this group of cases is not sharply separable from
other instances of bronchitis, because in some cases death has occurred
before a purulent exudate has accumulated or in other instances a
purulent exudate has been displaced by edema. Table XXIX shows the
bacteriology of instances of purulent bronchitis:
TABLE XXIX
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