════════════╤═════════╤═══════════════╤══════════════════╤═════════════════
Type of │Number of│ B. │ │ M.
Disease. │Patients.│Influenzæ-Like.│Pneumococcus-Like.│Catarrhalis-Like.
────────────┼─────────┼───────────────┼──────────────────┼─────────────────
Early │ 24│ 14│ 17│ 6
Serious │ 13│ 13│ 13│ 9
Convalescent│ 11│ 8│ 11│ 6
────────────┼─────────┼───────────────┼──────────────────┼─────────────────
Total │ 48│ 35│ 41│ 21
Percentage │ │ │ │
of │ │ │ │
positives │ │ 73│ 86│ 43
────────────┴─────────┴───────────────┴──────────────────┴─────────────────
_Direct Smears from Nasopharyngeal Swabs_
It is recognized by most of the modern investigators that little
reliance can be put on the finding of B. influenzæ-like bacilli in
direct smears. The organism is markedly pleomorphic, occurring as
extremely small coccoid forms up to threads of various lengths.
Notwithstanding these morphological variations the organisms are usually
seen as tiny bacilli, and these are considered as the typical form. We
carried out a series of microscopical examinations of carefully made
smears from the throats of patients with influenza. Particular attention
was given to the occurrence of organisms resembling in morphology and
staining B. influenzæ, pneumococci and M. catarrhalis. We have divided
the cases roughly into three types—early, serious, and convalescent.
Table II shows our results. The term B. influenzæ-like was used for the
typical morphological picture so often described. Dr. Frost and Mr.
Scott carried out this portion of our work and their results are
interesting.
Blood cultures were done on 22 cases. Pneumococcus mucosus was grown
from one patient who three days later came to autopsy (Case 767). In
another case pneumococcus-like organisms were seen in smears from the
dextrose broth flask after 24 hours’ incubation. These, for some unknown
reason, did not grow on blood agar plates. After 48 hours smears made on
blood agar from the original flask gave a growth of B. influenzæ and a
M. catarrhalis-like organism. I consider this result a very
unsatisfactory one, being quite unable to explain the failure to grow
the pneumococci-like forms on transfer. Possibly the acidity developed
might account for it.