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PURPURA FULMINANS FOLLOWING A MILD CASE OF SCARLET FEVER

1929; BMJ; Volume: 1; Issue: 3560 Linguagem: Inglês

10.1136/bmj.1.3560.595

0959-8138

Thos. A. Pratt, H. W. O. Frew,

late-r research?usinig imiproved nmethods., obtainod nio more than 30 PKr cent. of p)ositive cultures by that time.Loeser' investigated the problemii still mor-e toioLuglilly, finidinig the uiterus sterile imnmediately after-delivery, but gradually beconling inficted so that 25 per ceint. of all cervical cultur-es were positive ont the firist day, 50 per vent.0ol thie secondti (lay, ndl 100 per cent.on the< thlilrt (lay of thle lUerperiumn, infectioni of the funduts uteri follow;Ving Ialter, r1eachling its height by the fiftlh day and afterI;ard diminxlishling.Tllis w&is confirlie(l by thle stiuld we (oll(li(-te(l at freqtuent iiitcrvals during teni dlays of a trial grolIj) of 12 cases.We founid the uter us to be invaded -lmnost at ol0e, positive culltures beiing obtainied in somne eatses within five to six hours of delivery; infection increased uiintil tile tliid day, persisted unichlanged oil diminiiished sligltly by the fiftlh day, and had almost disappeared by the eighth dlay.This progressive invasion, culminatinig at the tllird tt) the fifth day, affords a ready exp)lanation of the observed delav in the developmenit of psierperal pyrexia until thlis time.In one-third of a series of 74 febrile cases aiialysed by us,7 a rise of temperature occuirred on the thlird day, and in two-thirds fromi the second to tlhe fouritlh day inclusive.