NOTES ON A CASE OF APPARENT PULMONARY TLHKK 

 CULOSIS ASSOCIATED WITH THE CONSTANT 

 PRESENCE OF DIPHTHERIA-LIKE 

 ORGANISMS IN THE SPUTUM * 



Burt Ransom Richards, 

 Director, Boston Board of Health BacterioloRical Laboratory. 



On January 8, 1906, a sample of sputum from H S 



was submitted to this laboratory in one of the regular outfits to be 

 examined for the bacilli of tuberculosis. In the course of the rigular 

 routine the specimen was stained in steaming carbol-fuchsin for 

 five minutes, decolorized with acid-alcohol (5 per cent HCl), and 

 counterstained with Loeflfler's methylene blue. When examined 

 under the microscope, no bacilli of tuberculosis were found, but 

 the specimen contained large numbers of bacilli which mor- 

 phologically were indistinguishable from the bacillus of diphtheria. 

 In fact, no other species of organisms were apparent in thi' speci- 

 men, microscopically. As is usual in such cases, the attending 

 physician was requested to secure a second, and in this case uncar- 

 bolized, specimen. The second specimen was received on January 

 15, 1906, and from it the organisms in question were isolated, but 

 not without some diflSculty, owing to the presence of a large, rapidly 

 growing coccus which tended to spread and overgrow the di|)h- 

 theria-like organism. The cultural characteristics of the organism 

 were then studied as follows: 



Morphology. — Indistinguishable from the Klebs-Loeffler organ- 

 ism. A, C, and D types (Wesbrook) present; C types predt)mi- 

 nating. No spores. Stains by the ordinary stains, and by Gram's 

 and Neisser's stain. 



Hanging-block. — The post-fission movement called "snapping," and whiih 

 appears to be characteristic of the diphtheroid group, was here obser\-ed.' 



Agar stroke. — Filiform growth at first, later slightly plumose; elevation fla 



with slightly raised edges. Luster glistening. Topography smooth at first, later 



slightly contoured. Opaque, non-chromogenic. Consistency, butyric. Medium not 



discolored. 



♦Received for publication April 7, 1006. 



•Hill and Rickards. Rep. and Papers, Amer. Pub. Health .\ssch , j8, p. 470- 



327 



