SERUM TREATMENT OF LOBAR PNEUMONIA 609 



Advancing years is, in general, one of the most important fac- 

 tors in unfavorably modifying the outlook with lobar pneumonia. 

 As shown in the accompanying figure (Figure 4), the case fatality 

 rate is 22 per cent without and 8.3 per cent with specific treat- 

 ment in patients from ten to fifty years of age, and 60.7 per cent 

 without and 30.8 per cent with such treatment in patients fifty 

 years of age and over. Analysis of the data with respect to the age 

 of patients with and without specific therapy indicates that the 

 favorable results of treatment cannot be ascribed to a difference 

 in the ages of patients in the two groups. 



As previously noted, bacteriemia occurs in about a quarter of 

 Type I infections and in about a third of Type II infections. As 

 shown in the accompanying figure (Figure 5), the occurrence of 

 blood invasion in patients treated without antiserum greatly in- 



FlGURE 5 



TYPE I AND TYPE II CASES WITH AND WITHOUT BACTERIEMIA 



NOT TREATED WITH SERUM. NUMBER AND 



PERCENTAGE OF DEATHS 



Type I 



Type II 



Cultures 

 negative 



!»•'% 



254 cases, 46 deaths 



11111 13 -3% 



315 cases, 42 deaths 



Cultures 

 positive 



64.6% 



155 cases, 100 deaths 



76.2% 



227 cases, 173 deaths 



Note: Figures were collected from the literature. No cases of 

 the Massachusetts Pneumonia Study were included. 



creases the death rate. Thus the fatality rate in Type I cases with 

 negative cultures is 18.1 per cent and with positive cultures 64.6 

 per cent. The situation is much the same with Type II infections, 

 the death rate rising from 13.3 per cent with negative to 76.2 per 



