Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
History
Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
Case 141 stands alone as representing a class in which S. hemolyticus
was implanted upon a pneumococcus pneumonia during its course. In this
instance two throat cultures on alternate days after the onset of the
pneumonia were negative for hemolytic streptococci. Unfortunately the
last record of a throat culture is for one taken ten days before the
fatal termination of the case, and it can only be stated that the S.
hemolyticus infection was implanted within the last ten days of the
course of the pneumonia, perhaps on or about October 12 when bilateral
otitis media developed.
In Cases 285 and 730 hemolytic streptococci were found in the throats
five and six days respectively before the onset of pneumonia. They
represent the 2 cases of pneumonia which developed in patients isolated
in the streptococcus “carrier” ward. Case 285 is of particular interest
for several reasons. It is the only case of lobar pneumonia in the group
and happens also to be the only case from which B. influenzæ was not
obtained. S. hemolyticus was found only once on throat culture, i.e.,
five days before the onset of the pneumonia. Three throat cultures after
the onset of the pneumonia were negative. The case ran the course of a
lobar pneumonia. Eleven days after the onset (November 9) a small amount
of pleural fluid was diagnosed. Aspirated fluid on this date and again
four days later showed many streptococci in smears and pure cultures of
S. hemolyticus.
The remaining 6 cases belong to a group in which hemolytic streptococci
were first identified in the throats after the cases had been reported
to the laboratory as pneumonia suspects to be examined by culture before
transfer from the measles ward. In all these cases the culture taken at
this time was positive while all cultures taken before were negative. In
some cases, _e. g._, Cases 98, 147, and 281, throat cultures taken only
one or two days before the onset of the pneumonia were negative. In
these cases the onset of the pneumonia and the appearance of the
streptococcus in the throats appear to be simultaneous.
It should be noted that the period between the appearance of the
hemolytic streptococci in the throat and the development of the
pneumonia is very short in all cases. In this small group of cases S.
hemolyticus infection which has complicated pneumonia has been acquired
at or near the time of onset of the pneumonia.
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