The pathogenic values of pneumococcal types: The lesions produced in relation to virulence

Abstract

TIIE relationship between virulence and pulmonary lesion has already been describeci in this Journal (Gaslrell 1925) in a pneumococcus of type I. Further work with other strains of type I pneumococci, isolated from human sources, has confirmed the view that organisms of this type produce lesions both in the experimental rabbit and the human subject in agreement with the relationship there set forth. The niinimal lethal dose to mice being used as a measure of titre (Gaskell 1924) organisms of titre lower than 4 have practically no pathogenic effect; from 4 to 5 a bronchopneumonia is produced; a t about titre 5 a more extensive lobular lesion occurs; from 5 to 6 a lobar lesion takes place with or without extensive invasion of the pleura: and pericardium, which often renders the lobar lesion incomplete; from 6 to 7 a rapid direct invasion of the blood produces a true septiczmia with characteristic changes in the lung quite different in type.I n man, perhaps owing to the larger size of the lung, the invasion of the serous cavities, the pleurre and pericardium, is much more uncommon than in the rabbit and a lobar lesion is usually produced at titre 5 to 6 ; the septicEmic lesion is much more uncommon, except as a sequel to a true lobar lesion, but is found occasionally in children (Armstrong and Gaskell 1921). Whittle (1928) has estimated the titre of the pneumococci isolated from a number of cases of type I invasion in man and finds that the titre relationship closely corresponds to the above scale.The experiments to be described in this paper were undertaken in the expectation that pneumococcal type was of little importance from the pathogenic point of view, and that similar lesions could be produced experimentally in rabbits with pneumococci of type I1 and I11 and virulent organisms of group I V as easily as with type I. It was found however that the strains of such types which had been selected for experiment did not exactly conform to the behaviour of type I organisms ; both the type I1 and I11 pneumococci were not only more JOURN. OF PATH.-VOL. XXXI. S 2 R

What is Different About Serotype 1 Pneumococci?

“…Gaskell published a series of papers outlining his work on pneumococcal models of infection in mice [75]. He found serotype 1 pneumococci more readily caused infection compared with other serotypes but infection was less severe.…”

Studies on Respiratory Diseases

“…An insufficient number of mice that died after the inoculation of the virulent culture were examined, however, to draw the conclusion that the most virulent culture produces lobar pneumonia while the ones of lesser virulence produce bronchial pneumonia or localized growths. This conclusion has been drawn by Gaskell (1928), Whittle (1928) and Armstrong and Gaskell (1921). Since no mice showed a complete picture of lobar pneumonia, although the picture at times was lacking only in the massive number of polymorphonuclear cells and heavy fibrin deposits, it is thought that the resistance of the host plays as great a part in the production of lobar pneumonia as the virulence of the culture.…”

Studies on Respiratory Diseases

“…Wadsworth partially immunized a few rabbits with filtrates. The theory that the type of lesion produced experimentally is due to the virulence of the organism has been stressed by Lamar and Meltzer (1912), Gaskell (1925Gaskell ( , 1928, Armstrong and Gaskell (1921) and Whittle (1928).…”