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
This compilation does not readily lend itself to drawing any more
specific conclusions, but we cannot desist from expressing our opinion
that in the clinical study of this recent epidemic we find very little
that may not have been observed by clinicians in previous epidemics.
THE URINE AND BLOOD IN EPIDEMIC INFLUENZA
By PETER I. ZEEDICK, M. D.
Epidemic influenza, unlike other acute infectious processes as
diphtheria and scarlet fever, seemingly attacks the kidney in a rather
mild manner. This statement refers only to the uncomplicated cases, as
other bacterial or toxic agents do play a part in the nephritides
occurring so often with the pneumonias or other complications
following influenza. It is, however, true that in many simple epidemic
cases there is evidence of a transient mild nephritis, or possibly,
more correctly stated, a nephrosis. Some writers observed albuminuria
in 80 per cent. of the cases, while the incidence in other reports
varies from 4 to 66 per cent. It is not always stated with reference
to these figures that the patients clinically were free from the
common complication—pneumonia. The findings of various observers
differ greatly, but they all agree that acute nephritis as a serious
sequel is somewhat rare.
In the literature of the past epidemics general acknowledgment has been
accorded to the presence of albumin in the urine during the acute stage
of the disease. Many times this has received no further notice or
comment than “febrile albuminuria.” The association of occasional
hyaline and granular casts has also been mentioned. One is impressed
with the fact that the older observers laid but little emphasis on the
urinary findings. It also seems to be true that nephritis as a clinical
entity is not prone to follow the epidemics. In general, our conclusions
from the last epidemic are about the same.
The data for this paper was obtained from examination of 994 specimens
of urine from 750 patients; of this number 517 specimens were examined
at the Magee Hospital, where members of the S. A. T. C., all young men,
were treated, and 447 specimens from the Mercy Hospital, where, in
addition to the S. A. T. C., we had men, women and children. On account
of the large amount of material and work on hand, as a rule only one
specimen of urine was examined from each patient, but where
complications were suspected repeated daily examinations were made. We
have grouped our results in tables, so that the various points may be
more readily followed.
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