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
Phlebitis, in our series usually of the formal vein, occurred about as
often as it does in typhoid fever. The end result, however, is much
better than in typhoid. We have seen only one case where “the milk leg”
has resulted. Rest and elevation of the limb were all that we required.
In the acute stage, if pain was present, a light, carefully applied
icebag was added. It is important to rest the limb for at least two or
three weeks, and to caution the patient against remaining on the feet
too long for some weeks after recovery.
We saw a great deal of acute sinus infection, often occurring even while
the attack of influenza was present, but, as a rule, this complication
followed the attack. At times several weeks intervened. The ethmoidal
sinuses are most susceptible, but a considerable number of acute frontal
sinus infections were noted, the latter often immediately following or
occurring during the acute period of the influenza attack. The majority
of these infections appeared transient, and disappeared with a little
local treatment. In fact, in frontal sinusitis cold applications seemed
to be all that was necessary. With some of the more chronic infections
nose and throat surgery has been followed by relief of symptoms. Acute
suppurative otitis media, considering the number of influenza patients,
was not common. Ear drum puncture was done if necessary. We saw one case
of acute mastoiditis develop. The mastoid process was opened and
drained.
Acute suppurative meningitis, following or associated with pneumonia,
appeared on three occasions. The pneumococcus was cultured from the
spinal fluid in all cases. Anti-pneumococcus sera intraspinally (Type I
or the Kyes serum) should be given. The Type I serum is of value in a
similar group infection. We have had no experience with this method, but
some recoveries from pneumococcus meningitis have been reported after
the early use of serum given into the spinal canal.
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