Pneumococcic Pneumonia Research Articles

Penicillin Aerosol in the Treatment of Experimental Pneumococcus Pneumonia.

Summary1. The prophylactic effect of penicillin, whether administered by inhalation or parenterally, upon experimental pneumococcus pneumonia in rats, was negligible if the infection (intrabronchial) was produced with pneumococci suspended in mucin. If, however, the organisms were suspended in broth the prophylactic effect was such as to determine a 100% survival rate.2. When penicillin inhalations were given at intervals of 1, 3, 5 and 7 hours following intrabronchial infection with 100 M.L.D. of mucin-suspended pneumococci, a 73% survival rate resulted (9% for untreated controls) and the survival time of all treated rats which died was lengthened compared with that of the controls.3. If the penicillin treatment by inhalation was delayed for 18 hours after infection (permitting the establishment of lung consolidation and septicemia), and then given from the 18th to the 26th hour, at 2-hourly intervals, the survival rate of the treated animals was 69%.4. When penicillin inhalations were given in 2 series ...

Pneumococcus Pneumonia and Its Complications

Statistics on a relatively small number of cases of pneumococcus pneumonia in San Francisco have been presented. While our statistical data are small, it is in accord with the figures presented in larger series. There has been a constant reduction in mortality rate consistent with the introduction of newer therapeutic agents. Complications may be less and certainly the consequences of complications are less severe with the employment of the newer drugs. The high mortality rate formerly accompanying the positive blood culture have been drastically reduced by the use of these newer drugs. We must not overlook the fact that marked variations in the severity of infection and variation in morbidity influence the statistics in pneumococcus pneumonia to a large extent.

THE MECHANISM OF RECOVERY IN ACUTE BACTERIAL PNEUMONIA

Excerpt Although the treatment of acute bacterial pneumonia has been revolutionized in recent years by the advent of chemotherapy, the exact mechanism of recovery is not known. Pertinent to the pro...

PENICILLIN AND SULFADIAZINE, COMPARED WITH SULFADIAZINE ALONE, IN THE TREATMENT OF PNEUMOCOCCIC PNEUMONIA

Excerpt Until the discovery of penicillin, sulfadiazine and several of its analogues were recognized universally as the drugs of choice in the treatment of pneumococcic pneumonia. When penicillin w...

Optimum dose of sulfadiazine in treatment of pneumococcic pneumonia

Optimum dose of sulfadiazine in treatment of pneumococcic pneumonia

Paragonimus Westermanii: A Case Report

Infestation with the trematode Paragonimus westermanii (or lung fluke) is said to be of common occurrence in China, Japan, Formosa, and the Philippines, where it is the cause of “endemic hemoptysis.” In our own experience with approximately 20,000 Chinese hospital admissions, the disease has been observed but once, although we have been well aware of the condition and have made repeated wet-mount sputum examinations in patients with unexplained hemoptysis. The disease is contracted by ingestion of the fresh-water crab or crayfish, which harbors the larval form. The larvae promptly develop and make their way through the intestinal wall into the peritoneal cavity, and thence through the diaphragm, into the lung parenchyma, where they become encysted and produce symptoms. These flukes may be found in other viscera as well, even the brain, but the lung is the site of predilection. Ova are produced in large numbers and coughed up in sputum which is characteristically mucoid and rusty, not unlike that seen in pneumococcus pneumonia. The fluke is described as thick and fleshy, oval in shape, and measuring 8 to 20 mm. in length by 5 to 9 mm. in breadth. In pathologic specimens tumor-like swellings are seen throughout the lung, mostly peripheral and outlined beneath the pleura. The parasites are contained within these nodules. Sections of the lung reveal scattered areas of infiltration, in which are “burrow-like” cavities containing the flukes. These smaller channels may coalesce to form a larger cavity with bronchial communication. Case Report A 28-year-old Chinese soldier was admitted to the hospital on Sept. 22, 1943, because of coughing up blood. During the previous three or four years there had been frequent episodes of hemoptysis, with production of large amounts of blood especially during or after strenuous physical exertion. At times there were sharp pains in both sides of the chest, not noticeably associated with respiration. There had been shortness of breath on exertion and some loss of weight in the preceding two months, during which hemoptysis had been continuous. The patient had not felt feverish nor had there been night sweats. There was no history of bleeding from other orifices. The patient had been in the army one year. Prior to that he had spent his whole life in Szechuan Province. He had never lived on, or even been near, any large body of water and could not remember having eaten crabs, crayfish, or any other shellfish. His mother and grandmother were said to have been chronic blood spitters; his father had died with generalized swelling, and he had two siblings, both of whom were healthy with no history of hemoptysis. The patient was well developed and fairly well nourished. His temperature was 97.8° F., and his blood pressure 108 systolic and 68 diastolic. The mucous membranes were of fairly good color and no icterus was present. Eyes, nose, and throat were normal. There was no enlargement of the peripheral lymph nodes.

Electrocardiographic studies during and after pneumococcus pneumonia

Electrocardiographic studies during and after pneumococcus pneumonia

STREPTOMYCIN IN THE TREATMENT OF SURGICAL INFECTIONS

SURGEONS are called on to treat a number of infections which do not respond to the usual surgical measures or to the forms of chemotherapy that have been available. They are frequently complicated by the presence of intestinal fistulas, intestinal obstruction, urinary obstruction, pieces of dead bone, necrotic fascia or tendon and poor blood supply. Because of these factors and because several types of bacteria are usually present, it is difficult to compare these infections with one another or to classify them for purposes of evaluating therapy. In these respects, they differ significantly from such diseases as pneumococcic pneumonia, meningococcic meningitis, typhoid and gonococcic urethritis, all of which have a simple etiologic agent and run a fairly typical course. Examples of these infections can be found in any surgical service. They are usually difficult to treat, often persisting for many weeks. For these reasons it is important to search for

INTRAMUSCULAR AND SUBCUTANEOUS ADMINISTRATION OF PENICILLIN IN BEESWAX-PEANUT OIL

Of various methods described for prolonging the action of penicillin by delaying its absorption or excretion,1one of the most promising appears to be the intramuscular injection of penicillin-beeswax-peanut oil mixtures. First described by Romansky and Rittman,2this method is an adaptation of the technic of Code and his associates,3who obtained extended prolongation of the action of histamine, desoxycorticosterone acetate and heparin by mixing them with various oils and beeswax. In the original communications of Romansky and Rittman2it was noted that assayable levels of penicillin could be maintained in the blood stream for seven to ten hours following single intramuscular injections of penicillin-beeswax-peanut oil mixtures. Favorable clinical results have since been reported in the treatment of gonococcic urethritis 4 and pneumococcic pneumonia.5 During the past nine months mixtures containing various concentrations of penicillin, beeswax and peanut oil have been prepared and investigated in

COLD HEMAGGLUTINATION IN PRIMARY ATYPICAL PNEUMONIA AND OTHER COMMON INFECTIONS

Recent reports indicate that large amounts of a cold hemagglutinin appear frequently in the blood of patients with primary atypical pneumonia. 1 Apparently, this is not true of patients with other common infections of the respiratory tract, such as pneumococcic pneumonia, the common cold, influenza and pulmonary tuberculosis. 2 In view of the simplicity of the titration of cold agglutinin in the serum, this procedure promises to be of value as a practical aid in the differentiation of primary atypical pneumonia from the other common types of pneumonia. This differentiation is often difficult, since no clinical or laboratory finding is characteristic of the former syndrome. 3 During the winter and spring of 1943-1944, we studied the phemonemon of cold hemagglutination in 115 patients with pneumonia, in 257 patients with other infections and in 100 normal hospital personnel. This was done to evaluate further the specificity and significance of high titers

OPTIMUM DOSE OF SULFADIAZINE IN TREATMENT OF PNEUMOCOCCIC PNEUMONIA

Extensive experience with the sulfonamide drugs in clinics throughout the United States has established sulfadiazine as the drug of choice in the treatment of pneumococcic pneumonia because of its greater efficacy and lower toxicity.1Hence it is important to establish its optimum dose in order that it may be used with maximum effectiveness. The initial dose of sulfadiazine usually advocated is 4 or 5 Gm.2However, it varies from 23to 711Gm. A maintenance dose of 1 Gm. every four hours is usually given,4although 1 Gm.5 or 2 Gm.1ievery six hours have also been used. It has been demonstrated1ithat, since sulfadiazine is excreted slowly, a proportionately higher dose given every six hours is as effective in maintaining adequate blood concentrations as is a four hourly dose. Early in the use of sulfadiazine, its administration by the intravenous route was reserved for critically ill

RECURRENT PNEUMOCOCCIC MENINGITIS FOLLOWING SULFONAMIDE THERAPY

Pneumococcic meningitis in the past has been an extremely fatal condition, a review of cases recorded before 1937 revealing only 185 cures in the entire literature.1This discouraging situation has been greatly modified by the use of chemotherapeutic agents. The wise use of sulfonamides early in pneumococcic pneumonia and other pneumococcic infections has prevented an undetermined number of meningeal complications, and the intensive use of these drugs has resulted in many apparent cures of well established pneumococcic meningitis. In addition it appears that occasionally the use of sulfonamide drugs may result in arrest of meningeal manifestations without cure, and that temporary remissions may be followed by relapses displaying typical signs of meningitis of greater or less severity. This relapsing form of pneumococcic meningitis may be regarded as a new clinical phenomenon which has thus far been reported in only 3 cases2and in each instance after more

Pitfalls in the Diagnosis of Atypical Pneumonia

We have had the impression that primary atypical pneumonia has been considered a disease easy to diagnose and simple to handle. This has been due, at least in part, to the very low mortality and the lack of effective specific therapy. It is hoped that this will serve to emphasize the following points: 1. Frequently it is very difficult, if not impossible, to differentiate primary atypical pneumonia from pneumococcic pneumonia. This should be done, if possible, in order that specific therapy be administered if indicated and withheld if not indicated. 2. Primary atypical pneumonia might often simulate pulmonary tuberculosis in its various manifestations and on rare occasion might be confused with pulmonary tumor. 3. It might well be impossible to differentiate primary atypical pneumonia from bronchiectasis during the acute stage. In a case of suspected bronchiectasis following primary atypical pneumonia, it is well to allow a period of observation and repeat the bronchogram before deciding upon surgical treatment of the bronchiectasis. The importance of differentiating primary atypical pneumonia from this and the conditions mentioned above is self-evident.

THE TREATMENT OF PNEUMOCOCCIC MENINGITIS WITH PENICILLIN

Pneumococcic meningitis remains as one of the acute infections most difficult to treat successfully. Before the introduction of the sulfonamides it was almost invariably fatal. Even with the very vigorous use of sulfonamides and type specific serums the results have been far from satisfactory. The case fatality rate has been reported to vary from 58 per cent¹to 80 or 90 per cent,²depending on the type of case received in the institution in which the study was made. Since pneumococci are highly sensitive to small amounts of penicillin, and since this agent is very effective in pneumococcic pneumonia,³much can be expected from its employment in pneumococcic meningitis.² Our purpose in the present report is to detail our experience with the use of penicillin in the treatment of 16 patients with pneumococcic meningitis and to compare the results with those obtained in 40 consecutive patients

Treatment of pneumonia with a single dose of sulfadiazine

<h2>Summary</h2> Uncomplicated pneumococcus pneumonia in children seems to respond as promptly to a single dose of sulfadiazine as to continued doses of this drug. The temperature dropped to normal in from 4 to 96 hours, or an average of 38.4 hours, following the single dose, and in from six to 100 hours, or an average of 40.1 hours, when a full course of sulfadiazine was given. No toxic manifestations appeared in twenty-five children following a single dose of from 0.15 to 0.3 Gm. of sulfadiazine per kilogram of body weight, not exceeding a maximal dose of 5.0 Gm. of sulfadiazine. The single dose treatment is simpler, less expensive, and may decrease the risk of toxic manifestations and the sensitization to the drug. Three patients with pneumonia complicated by otitis media did not respond to the single dose treatment. The single dose treatment is not recommended for hospitalized, serious, or complicated cases of pneumonia but as an expedient for ambulatory cases or occasions where proper care is lacking.

CLINICAL ASPECTS OF PRIMARY ATYPICAL PNEUMONIA

The increasing incidence of primary atypical pneumonia in certain army hospitals in combination with its frequently prolonged febrile period and slow convalescence is rapidly making it one of the most important causes of man days lost from duty in the military service. The appearance of this disease in significant numbers of cases at the time the medical literature was heralding the conquest of pneumococcic pneumonia is but another indication that medicine will never become a static science. Recent reports by a commission representing the Surgeon General (Dingle, Abernathy and others¹), Dingle and Finland,²Reimann,³Seeds and Mazer,⁴Campbell and his collaborators⁵and MacLeod⁶have thoroughly reviewed the present state of knowledge regarding causation, clinical aspects, epidemiology, x-ray appearance and treatment. It has been shown that primary atypical pneumonia, as the name suggests, is a heterologous group of diverse causation. Occasional cases and groups of

Pneumococcic meningitis and endocarditis Following fracture of the skull

In this report, we have seen a fracture of the skull which was followed by pneumococcic pneumonia type VII and meningitis. Although the meningitis improved upon sulfapyridine therapy, the patient succumbed to a pneumococcic type VII endocarditis superimposed on an old rheumatic heart lesion which was demonstrated upon autopsy.

Epidemiology of Pneumococcus Pneumonia

Epidemiology of Pneumococcus Pneumonia A Study, Including Bacteriological and Serological Observations in a Rural Community during a Season of High Incidence * Edward S. Rogers, Anne M. Bahlke, and Albert H. Harris, II CopyRight*Presented before the Epidemiology Section of the American Public Health Association at the Seventy-First Annual Meeting in St. Louis, Mo., October 29, 1942. https://doi.org/10.2105/AJPH.33.6.671 Published Online: August 29, 2011

NEWER KNOWLEDGE CONCERNING THE INCEPTION OF PNEUMONIA AND ITS BEARING ON PREVENTION

Article1 January 1943NEWER KNOWLEDGE CONCERNING THE INCEPTION OF PNEUMONIA AND ITS BEARING ON PREVENTIONO. H. ROBERTSON, M.D.O. H. ROBERTSON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-18-1-1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDespite the many recent advances made in the recognition and detection of the etiological agents causing acute pneumonia, the problem of the origin of this disease is still unsolved. Evidence both clinical and experimental points to the air passages as the route of infection, but the question as to how the pathogenic microörganisms gain access to the bronchial tree and what conditions are necessary to cause pulmonary infection, remain largely unanswered. It is probably a significant fact that the bacteria causing pneumonia (chiefly pneumococci, streptococci, staphylococci) are normal inhabitants of the upper respiratory tract at one time or another. Although...Bibliography1. SMILLIELEEDER WGFS: Epidemiology of lobar pneumonia, Am. Jr. Pub. Health, 1934, xxiv, 129-138. CrossrefGoogle Scholar2. STILLMAN EG: Presence of bacteria in lungs of mice following inhalation, Jr. Exper. Med., 1923, xxxviii, 117-126. CrossrefGoogle Scholar3. GRAESERROWE JBAH: Inhalation of epinephrine hydrochloride for relief of asthma in children, Am. Jr. Dis. Child., 1936, lii, 92-99. Google Scholar4. STILLMANBRANCH EGA: Experimental production of pneumococcus pneumonia in mice by inhalation method, Jr. Exper. Med., 1924, xl, 733-742. CrossrefGoogle Scholar5. ROBERTSON OH: Instance of lobar pneumonia acquired in laboratory, Jr. Preventive Med., 1931, v, 221-224. Google Scholar6. 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Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Read at the St. Paul meeting of the American College of Physicians April 22, 1942.From the Department of Medicine and the Douglas Smith Foundation for Medical Research of the University of Chicago, Chicago, Illinois. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Changing Fate of Pneumonia as a Public Health Concern in 20th-Century America and BeyondArt und Zustandekommen kombinierter Wirkungen von Virus- und Bakterien-InfektionenKlebsiella pneumoniae (Friedlander's Bacillus) Infections in InfancyA revaluation of the pneumonias of infancy 1 January 1943Volume 18, Issue 1Page: 1-14KeywordsBacteriaPathogensPneumoniaPulmonary diseasesRespiratory system ePublished: 1 December 2008 Issue Published: 1 January 1943 Copyright & PermissionsCopyright, 1943, by The American College of PhysiciansPDF downloadLoading ...

ETIOLOGY OF ATYPICAL ("VIRUS") PNEUMONIAS

During the past few years an increasing amount of attention has been given to a pneumonic syndrome which differs sharply from pneumococcic lobar pneumonia and from other familiar pneumonias of known causation. It has occurred in two general forms, one represented by a small proportion of cases of pneumonic involvement in epidemics of mild disease of the respiratory tract, like those cases described by Bowen,1Allen2and most other authors, and the other represented by isolated, sporadic, nonseasonal cases of severe disease, occurring chiefly in persons over 30 years of age. In the former the incubation period appears to be a matter of a few days, and in the latter it is longer, up to two weeks or more. Both forms are characterized by a gradual onset with dry inflammation of parts or all of the mucosa of the respiratory tract; chills or chilliness; slowly rising fever lasting