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
The onset of pneumonia in this group of cases occurred from four to nine
days after the onset of influenza and with few exceptions was ushered in
by a chill and pain in the chest. In several instances the patient had
apparently recovered from influenza as evidenced by fall of temperature
to normal. After twenty-four to seventy-two hours of normal temperature
the patient would have a chill and develop lobar pneumonia. In the
majority of cases, however, lobar pneumonia developed while the patient
was still sick with influenza. The course of the disease, symptomatology
and physical signs were quite characteristic of lobar pneumonia and
require no special comment. Recovery by crisis occurred in 21 cases, by
lysis in 8. Pneumococcus empyema developed in 3 cases, fibrinopurulent
pericarditis in 3 and all but 1 of these 6 cases terminating fatally.
In Table XV 5 fatal cases of lobar pneumonia, which illustrate some of
the unusual features of the disease when it follows influenza, have been
summarized. The first 2 cases represent examples of recurring attacks of
pneumonia which developed shortly after recovery from the first attack,
in both instances being due to types of pneumococci different from those
causing the first attack. The third case represents an example of
superimposed infection of the lungs with hemolytic streptococci and
staphylococci during the course of a pneumonia due to Pneumococcus IV
and disappearance of the latter organism from the tissues so that it was
not found at time of necropsy. The last 2 cases are examples of
fulminating rapidly fatal cases of lobar pneumonia associated with mixed
infections of pneumococci and hemolytic streptococci, the streptococci
probably being secondary in both cases. Cases like the few examples
cited above, which occurred not infrequently throughout the epidemic of
influenza, serve to illustrate the difficulties which may be met in
attempting to correlate the clinical, bacteriologic and pathologic
features of pneumonia following influenza unless careful bacteriologic
examinations are made both during life and at the necropsy table in the
same group of cases.
TABLE XV
CASES OF LOBAR PNEUMONIA FOLLOWING INFLUENZA
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