A pathogenic diphtheroid bacillus from a fatal case of meningitis

Abstract

THE reccnt studies of Rarratt (1933) and of Petrio and McClean (1934) have emphasised that members of the genus Corynebacterium other than C. diphtherk may be pathogenic for man. That such organisins may be found associated with epidemic disease is suggested by the observations of Gilbert and Stewart (1928-29) who described three outbreaks associated with milk infection traced to carriers of a diphtheroid bacillus which they named C. ulceram. The clinical condition was not of the same mild type as bacteriological diphtheria " as was shown by the fact that one case proved fatal with extensive lesions in the throat. Schultz et al. (1933-34) havc observed a case which throws yet another light on the pathogenicity for man of the diphtheroid bacilli, the infection being en invasion of the meninges by a previously uiidescribed type which they name C. parwulum. The present paper describes fat,al case of meningitis due to an organism resenibling that described by Schultz and his co-workers. It is of interest because the lesions produced appear to have resulted from invasion by a non-toxigenic typo of diphtheroid bacillus. Report of m e .Labourer engaged in bridge building. No history of trauma. Onset, 28.10.34, with shivering, malaise and gcnerdisetl pain in body and limbs. Pationt was seen by his medical tittendant the following day when his temperature wm 100.4" F. but no locnlising signs were present. Faeces nnd urine passed, no vomiting. Temporature 103, pulse 78, respiration 24. By the cvaning of the same day the patient's condition had deteriorated, tcmpcratiire being 104.6, pulse 84 and respiration 30. Rigidity of back muscles was present ; patient sent to hospital. On admission, 31.10.34 (4th day of illneM), ptxtiont very distressed and rather delirious, with some neck rigidity : Kornig's sign strongly positive : Brudzinski's sign positive. Clinical hktvry. E. F., aet. 37. 31.10.34. Loss of power on right side, notably hand and arm. 299 240 H . J . GIBSON 1.11.34. Temperature 105. Pulse 104 rising to 128. Rcspiration 36 rising later to 48.Lumbar puncture performed, thc fluid being clear and under reduced pressuro (40 drops per minute). Some improvement in goncral condition followed lumbar puncturu.The patient died the following day with hyperpyrexia. His condition rendered physical examination diflicult, but throughout the coupso of the illness physical sigm of edema at both lung bases were observed. Tho duration of illnoss was thus 6 days. W.B.C. 12,300.Autopsy. Along the vertex of the brain there was considerable thick purulent exudate extending laterally over the superior surfaces of the hemispheres. Base free of pus. Cerebrospinal fluid turbid. Brain substance showed little change, slight congestion underlying the inflamed meninges. No evidence of any abscess. Both middle ears and the sphenoidal, ethmoidal and frontal sinuses were free from evidence of infection. Lungs congested and cedematous at both bases. The remaining viscera presented the changes associated with fever and non-specific toxsinia. BACTE...

Two Cases of Listerial Meningitis in Infants

“…The following two cases of listerial meningitis in infants occurred near Edinburgh, as did the previous case of Wright and Macgregor, mentioned above, and the case of Gibson (1935).…”

“…One of these was a human strain from East Germany isolated in 1953, the other was the Gibson strain, which was isolated in Edinburgh. This last strain was obtained by Gibson (1935) from a fatal human case of meningitis which occurred some 20 miles south-west of Edinburgh. It is now known under its N.C.T.C.…”

Maternal and Neonatal Listeriosis: Report of Case and Brief Review of Literature of Listeriosis in Man

“…In the meanwhile Schultz et al (1933-4) in California reported the case of a nurse with meningitis due to a new Gram-positive bacillus, and Gibson (1935) in Scotland isolated from another case of meningitis a " diphtheroid " which he noted resembled the bacillus described by Schultz et al (1933-4). Cultures of these two bacteria, together with one of the original strains of Murray, Webb, and Swann (1926) and one from Pirie (1927), were examined and compared by Webb and Barber (1937) who "failed to find any material difference " between the four strains, in spite of their diverse origin, and concluded that further cases of listeriosis in man were likely to be reported from widely separated districts.…”

Listerial Meningitis in Infancy

“…In the United Kingdom reports of 14 cases have appeared (Gibson, 1935;Wright and Macgregor, 1939;Edmunds, Nicholson and Douglas, 1957;Mair, Mair, Stirk and Reid, 1957;Turner, Dawson and Pryce-Jones, 1958; Barrow and Pugh, 1958;Lane, Watling and Marshall, 1959; Moore and Whitmore, 1960;Librach and Seth, 1961;McKinnon and Swithinbank, 1961;Harding and Brunton, 1962), 5 of which occurred in the newborn period. This paper describes a further 3 cases of listerial meningitis in infancy from the Birmingham Children's Hospital and remarks on the bacteriological difficulties encountered in making the diagnosis.…”