Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
The colonies most liable to be confused with those of B. influenzæ are,
therefore, those of B. xerosis, immature colonies of the Gram negative
cocci and certain colonies of the streptococcus viridans group.
Transfers should always be made to heated blood agar of all colonies
suggestive of B. influenzæ, or when the growth of the B. influenzæ has
only occurred in the more crowded portions of the plate, and it is
difficult to pick pure cultures, attempted pickings should be made to
this medium for further platings. It is frequently necessary to make
further blood agar plates from the original blood agar, blood broth or
heated blood agar cultures after longer incubation periods, depending on
the findings in smears from these media. The heated blood agar is the
best of these to encourage the growth of B. influenzæ. It must, however,
be used at once, or within a very few days of its preparation, and
cannot be kept on hand as a stock medium. I have not found it as useful
for plating because of the difficulty of differentiating colonies. The
phenomenon of the star-like and more luxuriant growth of the colonies of
B. influenzæ about colonies of other bacteria has often been noted, and
will be referred to in a later portion of this report. Here it may be
said that this is at times a marked feature of certain mixtures and must
be recognized in studying the plates. The finding of B. influenzæ in
picks from apparently isolated colonies of other forms is not uncommon,
and is the same type of difficulty which I have discussed in papers on
streptococci. It is important to recall, in connection with cultures
taken from the lungs at autopsy, the experimental work of Norris and
Pappenheimer, who showed that B. prodigiosus put in the mouth
immediately after death could be recovered from the lungs in over 50 per
cent. of the cases studied.
_Results of the Author_
In Table I are shown my results from the 32 cases which came to autopsy.
The B. influenzæ was isolated from one or more sources in 25, making a
total of 78 per cent. Most of the negative cases probably also had this
organism, but I did not grow it from the material which I used for
culturing. The work of others would indicate that it may have been
present in other regions, such as the sinuses of the head or other
portions of the lung and respiratory tract. The positive results show B.
influenzæ present in 20 out of 30 cases from the bronchi; in 13 of 28
from the lungs; in 2 of 14 from the pleural cavity; in 9 of 26 from both
bronchi and lung where both were cultured; in 8 of 26 from the bronchi
with the lung negative; in 3 of 26 from the lung with the bronchi
negative; once of 10 from the pleural cavity with both the bronchi and
the lung negative, and once from all three sources.
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