Читать книгу Epidemic Respiratory Disease. The pneumonias and other infections of the repiratory tract accompanying influenza and measles онлайн

58 страница из 67

Pneumonia complicating influenza presented a very diversified picture and appeared to have only one constant character, namely, that influenza was the predisposing cause. It may be best classified on an etiologic basis since the clinical features to some extent and the pathology to a much greater extent depended upon the infecting bacteria in a given case.

Bacteriologic examination showed that a very large proportion of the cases was due to infection with the different immunologic types of pneumococci or to a mixed infection with B. influenzæ and pneumococci. The types of pneumococci commonly found in normal mouths, namely, II atypical, III, and IV, comprised approximately 88 per cent of these, the highly parasitic Pneumococci Types I and II, but 12 per cent. A small number of cases were due to hemolytic streptococci or to mixed infection with B. influenzæ and S. hemolyticus. No certain evidence was obtained that pneumonia was due to B. influenzæ alone. This organism was present in varying numbers, however, in approximately 80 per cent of the sputums examined, and it seems fairly certain that it must have played at least a part in the development of the pneumonia in many of the cases in which it was found. Superimposed infections with other types of pneumococci than those primarily responsible for the development of pneumonia, with hemolytic streptococci and with Staphylococcus aureus occurred frequently in cases of pneumococcus or mixed pneumococcus and B. influenzæ pneumonia and undoubtedly contributed to a considerable extent in increasing the number of deaths.