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
Before drawing sweeping conclusions against the invasion of the blood by
B. influenzæ it must be remembered that the quantity of blood used has
been generally only about 10 c.c., and often much less, the difficulty
of observing growth if the culture is pure has been largely overlooked,
the use of more favorable media than blood agar and the possible
inhibitory action of influenzal blood, as suggested by Wittingham and
Sims, Rivers and others, has not been considered, and further that
sufficient care has not been exercised to obtain blood at the most
favorable period in the disease. It may be recalled that the problem is
quite similar to that of demonstrating the organisms in the blood in
patients with streptococcus viridans bacteremia.
All the available evidence, however, points to the invasion of the blood
in influenzal infections as being a very fleeting one. Unless this is
true, it would be surprising in the many hundreds of blood cultures
which have been taken in the concentrated study of patients during the
recent pandemic, if more successful cultures had not been obtained.
General infections with localization of B. influenzæ in different parts
of the body are here of interest—such as that reported by Slawyk and
others. Whether the strains causing meningitis, and which apparently
more frequently invade the blood, are really different members of the
hemophilic group or only forms with a higher invasive power is still, I
believe, an open question.
_Endocarditis_
In endocarditis the B. influenzæ is probably, after streptococci, the
organism most frequently isolated from the blood. Rosenthal from heart’s
blood at autopsy, Schlangenhaufer, Jehle two cases, Horder (1907) six
cases, and who believed he was the first to isolate B. influenzæ from
the blood, Tedesko in a number at autopsy, Spat, F. J. Smith, Saathoff,
Libman four cases, Sacquepee, McPhedran, Mann, Rainaford and Warren
three cultures from two patients, and a number of others all bear
witness to its frequency.
Public-domain text, read in full here on John Shaqi.
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