392 PATHOGENIC MICROORGANISMS 



Especially dangerous are boils about the nose and lips, and not 

 infrequently infections in these locations may extend rapidly, and 

 cause fatal septicemia. 



Impetigo contagiosum, a skin disease consisting of boil-like in- 

 flamed papules and occurring particularly in young children, is 

 caused by staphylococci. 



In suppurative lesions of the bones, or osteomyelitis, staphylococci 

 are the most frequent causative agents. This may result, after 

 compound fracture, by infection from without, or not infrequently 

 staphylococci will lodge in the site of mechanical injury of bone 

 or fracture, reaching the focus through the circulation. The lesions 

 produced in bone may consist of slow localized abscesses, or may 

 extend along the medullary canal of the entire bone. 



In addition to these most common lesions, staphylococci may 

 cause abscesses in almost any part of the body. In cases in which 

 resistance if low and the staphylococci particularly virulent, sep- 

 ticemia may follow in any of these. Unlike the rapid, acute sep- 

 ticemia death, however, which is likely to ensue when similar general 

 infection with streptococci takes place, staphylococcus generalization 

 is apt to lead to secondary foci in kidneys, liver and other organs. 

 This leads to the condition of pyemia in which an irregular septic 

 temperature with frequent chills are characteristic. Blood culture 

 in such cases will give a clue to the nature of the infection. 



Ascending infections of the genito-urinary tract, cystitis and 

 pyelonephritis, may be caused by staphylococci. 



Staphylococcus empyema and peritonitis are not particularly 

 common, but may occur. 



Puerperal sepsis, while not as commonly a staphylococcus infec- 

 tion, as it is a streptococcus lesion, may occur. 



By some writers staphylococci have been held responsible for 

 rheumatism, but there is no convincing evidence of this. 



Staphylococci may also appear in meningitis. It is a curioi 

 fact that occasionally a very low grade staphylococcus may get int< 

 the meninges, and cause a very slow and apparently mild meningitis. 

 We have seen one such case caused by a staphylococcus albus recover, 

 and another which died after a prolonged illness in which the 

 organisms were repeatedly isolated from the spinal fluid, and, at 

 autopsy, in which the origin was a cerebellar abscess. 



Prolonged chronic infection with staphylococci may give rise to 

 the so-called amyloid changes in liver, spleen and kidneys. 



