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
Gastrointestinal symptoms were insignificant: 8 patients complained of
nausea early in the disease and 6 of them vomited. Diarrhea occurred in
only 1 case, constipation being the rule. The spleen was palpable in 21
cases, but this is of doubtful significance, since nearly all the
patients came from malarial regions. Jaundice was not noted. Aside from
the profound depression, sometimes amounting to stupor, mental symptoms
were not noted except in 1 case which showed a mild delirium.
Influenza, although _per se_ a self-limited disease of short duration,
frequently leads to the development of serious complications, the most
important of which are pneumonia and purulent bronchitis with a varying
degree of bronchiectasis. In the group of 100 cases of influenza
studied, purulent bronchitis developed in 36 instances, pneumonia in 15;
in 3 cases there was lobar pneumonia, in 12 bronchopneumonia. Further
discussion of these complications is reserved for the sections dealing
with them in detail. Other complications were relatively rare. Otitis
media occurred in one case and frontal sinusitis in one. No fatalities
were observed among cases of uncomplicated influenza, the deaths that
occurred being invariably associated with a secondary pneumonia due in
nearly all instances to secondary infection with pneumococci or
hemolytic streptococci.
Purulent Bronchitis
It has been stated that a considerable number of cases of influenza
developed a more or less extensive purulent bronchitis. This term is
used as descriptive of a group of cases showing clinically evidence of a
diffuse bronchitis as manifested by numerous medium and fine moist râles
scattered throughout the chest and evidence of a definitely purulent
inflammatory reaction as indicated by the expectoration of fairly
copious amounts of mucopurulent or frankly purulent sputum. This
condition is regarded as quite distinct, on the one hand, from the
common type of mucoid bronchitis frequently associated with “common
colds” and a fairly common feature of uncomplicated cases of influenza,
in which physical examination of the chest reveals only transient
sibilant and musical râles without evidence of extension to finer
bronchi, and, on the other hand, from bronchopneumonia.
=Bacteriology.=—Thirteen cases of purulent bronchitis following
influenza in none of which was there any evidence of pneumonia at the
time cultures of the sputum were made nor later were subjected to
careful bacteriologic study. Specimens of bronchial sputum were
collected in sterile Petri dishes and selected portions thoroughly
washed to remove surface contaminations before bacteriologic
examinations were made. The results are shown in Table XIII.
TABLE XIII
BACTERIOLOGY OF THE SPUTUM IN CASES OF PURULENT BRONCHITIS FOLLOWING
INFLUENZA
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