Endemic Purpuric Meningococcus Bacteremia in Early Life

Abstract

This paper is intended primarily to show the value of smears from purpuric lesions as an aid in the early diagnosis of meningococcus bacteremia.Netter and Salanier1 demonstrated the presence of meningococci in purpuric lesions in 1916. Previously in 1915, meningococci were found in direct smears of the blood by Coles.2 Drigalski3 has been credited with the first identification of meningococci from herpetic lesions associated with meningococcal infection. The organisms were also demonstrated in sections made from the purpuric lesions by Benda.4 Several other investigators 5 have confirmed these findings, that meningococci are present in the skin and in the cutaneous capillaries. Investi-

Toxic Epidermal Necrolysis

“…This is a contrast to most other cases of toxic epidermal necrolysis in which the fluid from intact blisters was sterile. Because isolated bullae may be a cutaneous manifestation of bacterial septicemia [162][163][164][165][166] more extensive cases resembling toxic epidermal necrolysis most likely represent the same phenomenon. "*' They probably do not represent secondarily infected drug-induced bullae.…”

Acute Bilateral Suprarenal Haemorrhage

“…Morrison (1943) considers the time limit to be twelve hours; in case 4, intra-vitam culture grew N. meningitidis, whereas culture twelve hours post mortem did not. A point of interest is the work of McLean and Caffey (1931), who, by staining smears and culturing the contents of purpuric blebs, isolated the meningococcus in 83 per cent. of cases.…”

Anaemia and Liver Therapy in Infancy and Childhood

“…The blood count showed :-Hoemoglobin 32 per cent., red cells 2,060,000, colour index 0 75 white cells, 9,100 (polymorphonuclears 51-5 per cent., lymphocytes 45.5 per cent.. large hyalines 3 0 per cent). There were anisocytosis and some polychromasia.…”