492 A MANUAL OF BACTERIOLOGY 



and other exanthemata. The streptococcus is usually of the 

 hsemolytic type, and is present in the lungs and sputum, but can 

 rarely be obtained from the blood except in primary septicsemic 

 cases. In combined pneumococcic and streptococcic cases the 

 pneumococcus may be obtained from the blood, but not the 

 streptococcus. Streptococci are the common cause of the so- 

 called deglutition pneumonia and of the broncho-pneumonia 

 following operations about the mouth and throat. 



Staphylococcal Pneumonia 



This is a rare form of broncho -pneumonia, only 13 out of 800 

 cases of pneumonia treated at the Rockefeller Hospital, 1913-18, 

 being of this type. The onset is insidious and rarely accompanied 

 with chill and localised pain. The sputum, which is very purulent 

 and like anchovy sauce in colour, contains large numbers of 

 M. pyoyenes, var. aureus. Blood cultures are also positive in half 

 the cases. The disease is very fatal, only two recovering out of 

 155 cases. 1 



Clinical Examination (Pneumonic Conditions) 



(1) In acute croupous pneumonia, the sputum is very viscid and 

 typically " rusty " in appearance, but frequently lacks this 

 character. In smears stained with Loffler's blue, and by Gram's 

 method, the pneumococci will probably be abundant in the early 

 stages, and other organisms comparatively scanty. The former 

 appear for the most part as encapsuled diplococci which are Gram- 

 positive. 



(2) In broncho -pneumonias a variety of organisms may be met 

 with pneumococci, streptococci, staphylococci, B. pneumonice, 

 B. influenzce, M. catarrhilis. In certain diseases the causative 

 organism of the disease may be present, e.g. the typhoid bacillus, 

 plague bacillus, diphtheria bacillus, etc. H?pmorrhagic sputum 

 may occur in streptococcal and plague pneumonias. In the latter, 

 numbers of short, bi-polar staining, Gram-negative bacilli will be 

 found in smears. The sputum of staphylococcal pneumonia is 

 very purulent, and at an early stage is typically of a dirty salmon - 



1 See Chickering and Park, Journ. Amer. Med. Assoc., 1919, vol. Ixii, 

 p. 617. 



