An original method of obtaining sputum from infants and children: With reference to the incidence of pneumococci in the nasopharynx

Abstract

A new suction method of obtaining sputum from infants and children has been described. With experience one is usually able on the first attempt to obtain sufficient sputum from either the larynx or the nasopharynx to carry out an examination by direct smear and typing by the Neufeld method. The laryngeal method is recommended in cases of suspected tuberculosis, whooping cough, or pneumonia due to mixed infection, while sputum from the nasopharynx is ideal for typing pneumococci. The nasopharynx has been suggested as a breeding ground for pneumococci and as the probable source by which pneumococci reach the lung in pneumonia of infants and children. In obscure febrile conditions in which the diagnosis seems to lie between an acute appendicitis and pneumonia, the finding of large numbers of pneumococci in the nasopharynx before any definite physical findings in the chest can be recognized is an indication that the child is suffering from a developing pneumonia; the subsequent course of the disease supports this view. The possibility that the condition is pneumococcic peritonitis must not be overlooked. A new suction method of obtaining sputum from infants and children has been described. With experience one is usually able on the first attempt to obtain sufficient sputum from either the larynx or the nasopharynx to carry out an examination by direct smear and typing by the Neufeld method. The laryngeal method is recommended in cases of suspected tuberculosis, whooping cough, or pneumonia due to mixed infection, while sputum from the nasopharynx is ideal for typing pneumococci. The nasopharynx has been suggested as a breeding ground for pneumococci and as the probable source by which pneumococci reach the lung in pneumonia of infants and children. In obscure febrile conditions in which the diagnosis seems to lie between an acute appendicitis and pneumonia, the finding of large numbers of pneumococci in the nasopharynx before any definite physical findings in the chest can be recognized is an indication that the child is suffering from a developing pneumonia; the subsequent course of the disease supports this view. The possibility that the condition is pneumococcic peritonitis must not be overlooked.