CHAPTER XXIII. 

 DIAGNOSIS OF INFECTIONS OF THE NASAL CAVITIES. 



IN taking material from the nasal cavities, for the bacteriological 

 examination, it is well to wash about the alae with sterile water and 

 then have the patient blow his nose on a piece of sterile gauze and 

 take the material for culture or smear from this. If the material is 

 purulent and located at some ulcerating spot, it is best to use a specu- 

 lum, and either touch the spot with a sterile swab or use a capillary 

 bulb pipette with a slight bend at the end. 



Normally, we find only white staphylococcus colonies and colonies of 

 short-chain streptococci. The M. tetragenus, B. xerosis and Hoff- 

 man's bacillus are also occasionally found. 



In some cases of ozena we may find an organism of the Fried- 

 lander type in pure culture. 



Biscuit-shaped diplococci, both Gram negative and positive, are 

 to be found either normally or in cases of coryza. M. catarrhalis has 

 probably been frequently reported as the meningococcus. Still, the 

 meningococcus has been found in the nasal secretion of patients with 

 cerebrospinal meningitis. 



Diphtheria involving the nasal cavity must always be kept in mind, 

 and in quarantine investigations the examination of the nasal secretion 

 culturally should be a part of the routine. 



The tubercle bacillus may be found in nasal ulcerations ; it is, how- 

 ever, only present in exceedingly small numbers. On the other hand, 

 one of the best diagnosistic procedures in leprosy is to examine smears 

 from nasal mucous membrane for the B. leprae. In such ulcerations 

 the bacilli are found in the greatest profusion. . ' M 



The gonococcus has been reported for the nose. Various fungi 

 have been reported from the nose, but in such a region the strictest 

 conservatism in reporting should be observed. 



Recently sporozoa have been reported in a case of nasal polyp. 



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