Staphylococcus aureus infection of the blood stream has always been considered with grave concern by all physicians because of the lack of specific therapeutic measures to cope with it properly and check its progress. Chemotherapy is now playing an increasingly important role in the treatment and control of acute infections of all types. Much has been said for the use of sulfanilamide and sulfapyridine (2-[paraaminobenzenesulfonamido]-pyridine) in this connection, but little has been reported on the use of these drugs and the results obtained in the treatment of Staph. aureus infections.The present interest in the treatment of staphylococcic bacteremia has prompted this report for its academic value.
REPORT OF A CASEF. W., a boy 8 years of age, was first seen by me on Aug. 31, 1940. He had first become sick on August 29, complaining of severe frontal headache, general malaise, running nose, redness of both eyes and a slight fever. On August 30 his temperature reached 101.5 F., the left eyelids became markedly swollen, the left nostril became obstructed and in general he felt very sick. He had never complained of a postnasal drip or any other trouble with his nose. There was no history of injury. Although he indulged a great deal in swimming and diving during the summer, he had not been in the water for three weeks before this illness. He had not had a cold for eight months. Examination revealed a moderate swelling on the left side of the forehead, extending from the left eyelids, which were tensely chemotic and slightly ecchymotic. The left eyeball was con¬ gested but freely movable. There was moderate tenderness in the region over the left frontal sinus and around the swelling on the forehead. The entire nasal mucous membrane was so congested and edematous that it completely obstructed the left naris. Over the left inferior turbinate was a fibrinous exúdate, which did not leave a bleeding surface on removal. The right naris was clear. Twelve grains (0.78 Gm.) each of sulfanilamide and sodium bicarbonate were given every four hours (the patient weighed 72 pounds [32.7 Kg.]). Three per cent ephedrine administered in the form of nasal drops and nasal packs failed to produce any shrinkage of the nasal mucous membrane. Inhalations of steam were used with, little or no effect. Cold compresses saturated with a 50 per cent solution of magnesium sulfate were applied constantly to the swelling on the forehead.On September 1 all of the symptoms became aggravated, and the temperature rose to 104 F. The patient did not have chills at any time during his entire illness. He was now admitted to the Prospect Heights Hospital. Physical examination gave negative results. The spleen was not enlarged, the neck was not rigid and the Kernig and Babinski signs were absent. Fluctuation was elicited over the swelling on the left side of the forehead ; this was aspirated with a heavy needle on a Luer syringe, and 1 cc. of a thick reddish fluid was obtained and cultured. A blood culture and a culture of material from the left nostril were ...