NOTES ON A CASE OF APPARENT PULMONARY TUBER- 

 CULOSIS ASSOCIATED WITH THE CONSTANT 

 PRESENCE OF DIPHTHERIA-LIKE 

 ORGANISMS IN THE SPUTUM .* 

 BURT RANSOM RICHARDS, 



Director, Boston Board of Health Bacteriological 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 regular 

 routine the specimen was stained in steaming carbol-fuchsin for 

 five minutes, decolorized with acid-alcohol (5 per cent HC1), and 

 counterstained with LoefBer'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 the 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 difficulty, owing to the presence of a large, rapidly 

 growing coccus which tended to spread and overgrow the diph- 

 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 predomi- 

 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 which 

 appears to be characteristic of the diphtheroid group, was here observed. 1 



A gar 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, 1906. 



'HiLL AND RICKARDS. Rep. and Papers, Amer. Pub. Health Assoc., 28, p. 479. 



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