Pneumococcus conjunctivitis / by Fred T. Tooke.

  • Tooke, Fred T.
Date:
[1906]
Catalogue details

Licence: In copyright

Credit: Pneumococcus conjunctivitis / by Fred T. Tooke. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    vealed quantities of pneumococci. Romer's anti-pnt'iiinococcic seruin was administered immediately but the day following the progress of the disease had not been stayed and pus was in tl)e anterior chamber. Local treatment and the employment of Romer's serum failed to check ^he disease, so that in four days the condition had proceeded to one of panophthalmitis with the usual results. Case B,—Admitted to hospital suffering from an acute keratoiritis of the right eye. The patient's general health was good but shortly after her admission she complained of pain and lachrymation in the formerly healthy eye. The onset was markedly acute, to such, a degree that, in twenty-fours hours the lids were tremendously infiltrated and the most pronounced chemosis conjunctivae was present so that the cornea could scarcely be seen. A rather profuse muco-purulent dis- charge was emitted from the palpebral fissure and examination of it showed pneumococci in large quantities. Iced applications of boracic acid and biborate of soda were applied to the lids and three or four days later all evidence of superficial inflammation had disappeared. These two cases are cited merely to illustrate the remarkable result which may follow an apparently benign infection of the pneumococcus with a coincident corneal wound; while a very acute attack with pro- found superficial disturbance may completely disappear in the course of a few days if the corneal epithelium has remained intact. An ordinary case of moderate intensity would appear somewhat as follows:—One first notices a rosy-red oedema of the lid margins, par- ticularly of the upper, and Morax regards this as characteristic; there is a rapid increase of the redness of the conjunctiva with moderate swell- ing and an occasional superficial false membrane formation so that at the crisis of the disease a profuse watery secretion containing a few purulent particles may be emitted between the lids and a marked red- ness of the bulbar conjunctiva be present, with an occasional phlyc- tenular formation at the limbus. One may occasionally notice tiny haemorrhages in the bulbar conjunctiva particularly in that portion covered by the upper lid; these hreraorrhages assume a yellowish red colour and disappear during the process of resolution of the disease. This picture may pursue a critical course and the rapid disappearance of symptoms may follow in a short time after the crisis when the ex- citing cocci will disappear rapidly; the so-called Xerosis bacillus and the staphylococcus alone remaining. This condition is frequently noted in the new-bom. While a very similar picture of acute inflammation may be produced iiy the Koch-Weeks baxjillus yet the critical course of the disease with