88 STUDY AND IDENTIFICATION OF BACTERIA 



Sudden death after administration of antitoxin has been reported 

 in cases of status lymphaticus. (See anaphylaxis). 



In obtaining material from a throat, be sure that an antiseptic gargle 

 has not been used just prior to taking the throat swab. The part of the 

 swab which touched the membrane or suspicious spot should come in 

 contact with the serum slant. This is best accomplished by revolving 

 the swab. An immediate diagnosis is possible in probably 35% of cases 

 by making a smear from a piece of membrane. In doing this Neisser's 

 stain or the toluidin blue stain are usually considered the most satis- 

 factory. I prefer the Gram stain, however. The diphtheria bacilli 

 found in such smears are not apt to be clubbed and stain more 

 uniformly. 



If there is any doubt about the nature of an organism in a throat culture, always 

 stain: i. with Loffler's alkaline methylene blue for two minutes; 2. with Gram's 

 method, being careful not to carry the decolorization too far, and 3. by Neisser's 

 method. With Loffler's you obtain a picture which, after a little experience, is 



FIG. 28. B. diphtherias stained by Neisser's method. (Williams.') 



characteristic; at times the polar bodies show as intense blue spots in the lighter 

 blue bacillus. One is liable to confuse cocci lying side by side for diphtheria bacilli 

 with segmental or banded staining. This difficulty is not apparent when Gram's 

 staining is used. This gives us great information, as the diphtheria and the pseudo- 

 diphtheria are the only small Gram positive bacilli usually found in the mouth. 

 The cocci are also well brought out. Neisser's stain gives a picture which, when 

 satisfactory, is almost absolutely characteristic. You have the bright blue dots 

 lying at either end of the light brownish-yellow rods. When first isolated from a 

 throat, the diphtheria bacillus is apt to stain characteristically by Neisser. Later 



