Diphtheria

Abstract

eighty clinical cases of diphtheria, seven sérologie types were isolated, but the morphology and sugar reactions do not indicate the sérologie strains. Neither are virulent and avirulent strains differentiated by sérologie tests.Eagleton and Baxter 3 also find a multiplicity of sérologie groups of B. diphtheriae. They have studied ten groups, and all but 16 of 348 strains of virulent B. diphtheriae could be placed in these ten groups. The technical difficulties and epidemiologic value of this work is discussed.Powell 4 states that the virulence of different strains of B. diph¬ theriae for the guinea-pig is variable in narrow limits only. The aviru¬ lent strains do not produce toxin. Single cells of B. diphtheriae can be isolated easily by the Barber method, and in culture single cells of the same strain show the same virulence for guinea-pigs. During two years time, covering about fifty generations of more than 300 strains of B. diphtheria on Loeffler's blood serum, there was no detectable change of the virulence.The same author found no significant morphologic changes in 299 pure line strains of B. diphtheriae during a period of two years. Con¬ siderable stability was also found 5 in the agglutination and absorption of agglutinin tests on single cell cultures from strains of B. diphtheriae. It was not possible to split a parent culture by agglutination tests.Stovall, Scheid and Nichols 6 have found that Staphylococcus aureus not only kills the B. diphtheriae when the two are grown together, but will also change the morphology of the organisms to such an extent that they no longer fall in the same Westbrook type. Streptococci, when grown in diphtheria cultures, do not produce such changes.Nigro 7 reports comparative bactériologie tests with various culture mediums in sixty cases of suspected diphtheria. He found that on Pergola's serum egg yolk medium the diphtheria bacilli grew luxuriantly while other bacteria were inhibited. This is a mixture of 50 c.c. of normal blood serum (beef, horse, etc.) with one egg yolk and 0.02 gm.

Angioma of the Larynx in Laryngeal Stridor of Infancy

“…Five of their 6 cases treated conservatively (4 with tracheotomy) died, 2 of the 3 treated surgically by laryngo-fissure and five of the six treated with radiotherapy were cured. Crooks (1954) describes two cases; one died before radiotherapy was given, and in the other the angioma recurred after removal of the laryngo-fissure and the child eventually recovered after radiotherapy. Treatment by ligature of one or more of the thyroid arteries or injection of sclerosing agents might be considered but we know of no reports of such cases.…”

“…The risks of irradiation must be balanced against the fact that it is a most effective method of treatment for an otherwise fatal condition. Surgical treatment by laryngo-fissure carries no such risk but there is the possibility of recurrence (Crooks, 1954) and the voice may be affected. Mr. W. Stirk Adams oto-laryngologist at the Birmingham Children's Hospital, has suggested that the tumour might be removed through an extended tracheostomy splitting the cricoid but leaving the thyroid cartilage intact.…”

Laryngeal Stridor in Infants and Children

“…Attention was drawn to this by Crooks (1954). The condition consists of a. cleft in the posterior wall of the larynx between the arytenoids.…”