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
Bacteriologic evidence that cases of pneumonia following influenza might
be due to B. influenzæ alone was very meager in the group of cases
studied clinically at Camp Pike; in fact, no convincing evidence was
obtained that such cases occurred. In one case B. influenzæ alone was
found in the sputum coughed from the deeper air passages, and in another
case B. influenzæ with a few colonies of S. viridans was found. Both
were cases of bronchopneumonia, mild in character, and recovered
promptly. They presented no clinical features by which they could be
distinguished from cases of pneumococcus bronchopneumonia.
It has been previously stated that B. influenzæ was found in all early
uncomplicated cases of influenza somewhere in the respiratory tract;
that it was present together with other organisms, notably pneumococcus
in the sputum from cases of purulent bronchitis following influenza; and
that it was found in the sputum coughed from the lung in approximately
80 per cent of cases of pneumonia complicating influenza. In 35 cases it
was very abundant, often being the predominating organism. In all these
cases, however, pneumococci or hemolytic streptococci were also present
in considerable numbers at the time of onset of the pneumonia. It is
impossible to say merely from the clinical and bacteriologic data under
consideration what part B. influenzæ played in the development of the
actual pneumonia in these cases. Discussion of this subject is therefore
reserved for the section of this report dealing with the pathology and
bacteriology of pneumonia following influenza.
Summary
Influenza as observed at Camp Pike presented itself as a highly
contagious infectious disease, the principal clinical manifestations of
which were, sudden onset with high fever, profound prostration with
severe aching pains in the head, back and extremities, erythema of the
face, neck and upper chest with injection of the conjunctivæ, and a
rapidly progressive attack upon the mucous membranes of the respiratory
tract as evidenced by coryza, pharyngitis, tracheitis and bronchitis
with their accompanying symptoms. In the majority of cases it ran a
short self-limited course, rarely of more than four days’ duration, and
was never fatal in the absence of a complicating pneumonia.
Bacteriologic examination in early uncomplicated cases of the disease
showed the B. influenzæ of Pfeiffer to be present in all cases, often in
predominating numbers. It was found more abundantly present during the
acute stage of the disease than during convalescence in uncomplicated
cases. No other organisms of significance were encountered by the
methods employed.
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