Infected Clots Research Articles

A standardized method of disinfecting infected blood-clots

1. A method is described for estimating the disinfecting power of chemical substances on small cylindrical blood-clots of standard dimensions (about 1·5 mm. in diameter) containing a measured number of bacteria (Staph. aureus). It is capable of giving guidance for the use of disinfectants under the described conditions.2. No practicable disinfectant regularly sterilized heavily infected clots (400,000 cocci) in 5 min. at 17–20° C.3. In 30 min. the following were the only substances that were uniformly successful with heavily infected clots: 2·5% iodine in aqueous KI solution; 50% Chloros, containing about 5% chlorine; 70% alcohol containing 0·1% acriflavine. (The first of the three was tested on a larger scale than the others, and its potency is therefore the more firmly established.)4. Reduction of the number of cocci in the clot increased the range of effective disinfectant solutions. Thus with 4000 cocci per clot regular clot disinfection was achieved in 30 min. with the following additional solutions: ethyl alcohol 70 and 50%; Chloros 25%; phenol 2·5% and lysol 1·25%. A few tests indicated that Zephiran (and probably CTAB) at 1 or 2% concentration would also pass this less exacting test.

THROMBOSIS OF THE SIGMOID SINUS: A CLINICAL ANALYSIS

Septic thrombophlebitis of the sigmoid sinus remains, as it has been for many years, one of the most intriguing complications of suppurative otitis media. Instances of this condition comprise but a small portion of the relatively large number of cases of suppurative otitis media associated with sepsis. The term as used signifies an infected clot, mural or occluding, from which particles gain entrance into the blood stream and produce septicemia. True septicopyemia with a positive blood culture and metastatic abscesses is not found in every case. The broader term "sepsis" is usually applied, indicating the condition of a patient who is acutely ill of an infection and who presents chills, intermittent high fever giving the "picket fence temperature curve," leukocytosis and secondary anemia. Having ruled out possible extra-aural causes of sepsis, one must bear in mind the fact that infecting organisms in the middle ear and mastoid may gain entrance

THROMBOSIS OF THE SIGMOID OR LATERAL SINUS

There is a difference of opinion in this country and in Europe regarding treatment of otitic sinus thrombosis. Dandy 1 questioned the necessity for ligation of the jugular vein or an attempt to remove an infected clot. Mygind 2 reported his results in two groups of patients with otitic sinus thrombosis who were treated by different methods. The first group included 98 patients observed during the period from 1915 to 1922, with recovery in 55 per cent. The treatment of these patients was: (1) diagnostic puncture of the infected sinus, (2) removal of the thrombus and (3) ligation of the jugular vein. Mygind's second group of 101 patients observed during the years from 1923 to 1930 were treated more conservatively, and 71 per cent recovered. In 93 of the 101 patients the infected mastoid cells were thoroughly opened, but nothing was done to the sinus or vein: 70 of these