No abstract

and probably also in bronchiectasis (Allison et al., 1943), is responsible for the formation of a very tenacious greenishyellow mucopus. Such pus in the nasopharynx may well produce a cough resembling a whoop. Summary From per-nasal swabs of 650 children aged 0-4 years 32 capsulated H. influenzae strains have been isolated. Type f was found 11 times, type e 8 times, and type b 6 times, the other three types occurring less often. The fact that the most frequently isolated types were not H. influenzae type b, while type b was the causative agent in all of 41 cases of H. influenzae meningitis occurring during the same period in Leeds and various other parts of England and Wales, suggests that this type is more virulent for man than the other five known H. influenzae typ2s. We are greatly indebted to Professor J. W. McLeod-for access to the bacteriological material. We are glad to acknowledge Dr. G. C. Turner's help in providing us with H. influenzae strains from the whooping-cough inquiry after one of us (B. D.) had left the department. REFRENCES

No abstract

No abstract

& d a g g e r ; Pediatrician, Leicester Royal Infirmary, Leicester, England.Four infants are described aged 12 days to five months in whom failure to thrive and persistent diarrhea were caused by subacute intestinal obstruction associated with anomalies of mid-gut rotation.ALTHOUGH it is well known that con-LTHC3UGH it is well known that congenital anomalies of the gut are a rare cause of the celiac syndrome in older children 7,8 no reference has been found in an article or pediatric surgical textbook 2--~,, &dquo;, 10, 12 to similar anomalies presenting in early infancy with diarrhea and failure to thrive. In our cases these symptoms resulted from subacute intestinal obstruction associated with abnormalities of mid-gut rotation.Case Reports Case 1. Brian G. was 12 days old when hospitalized on February 11, 1962, with a history of diarrhea for two days and vomiting for one day. He was the third child of healthy parents. Pregnancy and delivery were normal. Birth weight 9 lb. He was said to have regained his birth weight by the tenth day but two days later when he came into hospital he weighed only 7g lb. Although he was dehydrated the abdomen was a little distended. Serum bicarbonate level was 13 mEq./L. The dehydration and acidosis were corrected by intravenous infusions but he continued to pass loose foul-smelling stools with only occasional vomiting and at intervals he again became dehydrated and acidotic. Urine and CSF were normal as was a urinary amino acid chromatogram. Sweat analysis showed a sodium content of 21 rnEq.~'L. and chloride 25 mEq./L. ~Gastro-intestinal -ra~:~ studies (Fig. 1) on March 7 showed dilatation of the lower small bowel with delay in the passage of barium. At operation on March 15 (J. L.) a high mobile cecum and ascending colon were found with a Ladd's band across the second part of the duodenum. There was a volvulus of the small intestine on the superior mesenteric vessels. The band was divided and the mesentery untwisted. After operation an intravenous drip was maintained for two days and normal feeding then quickly resumed. On the day of operation he weighed 8gz lb. A month later he weighed 9% lb.