The Role Of The Typhoid Bacillus In The Pulmonary Complications Of Typhoid Fever.

Abstract

The fact that typhoid bacilli are not infrequently found in the lungs during an attack of typhoid fever is well established, but the effect of their presence is still uncertain. Artaud in 1885 was the first to mention the possibility of pulmonary invasion by typhoid bacilli, and he described typhoid-like bacilli in the lungs of two typhoidal patients dying of pulmonary apoplexy. According to Curschmann, lungs, the seat of gangrene, hypostatic splenization, or even lobar pneumonia due to the pneumococcus, undoubtedly may be invaded by typhoid bacilli. When one considers the constancy with which the typhoid bacillus enters the general circulation, and also that the organism has been obtained by a number of observers (Polgu&re, Montier, Koque and Bancel) from lungs in a state of congestion only then it is clear that the organism quite regularly enters the lungs during typhoid fever. Roque and Bancel obtained the bacillus six times in 16 attempts by lung puncture during life from cases showing only bronchitis or pulmonary congestion. They think that the typhoid bacillus is present in greater numbers in the pulmonary than in the systemic circulation and plays an important rCle in pulmonary complications of typhoid fever. Although the organism has been recovered repeatedly from the lung, there are in the literature but few cases in which the typhoid bacillus seems surely to have produced a definite pulmonary lesion. Several observations have been made recently at the Pennsylvania Hospital which throw some light upon the significance of the typhoid bacillus in pulmonary complications of typhoid fever.