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June 15, 1940


JAMA. 1940;114(24):2389-2390. doi:10.1001/jama.1940.02810240043012

Can tubercle bacilli pass through a normal kidney? This question involves the larger question of physiologic excretion of bacteria through normal kidneys. The experimental studies of Wyssokowitsch and the microscopic studies of Opitz, von Klecki and Koch demonstrate that bacteria injected into the blood stream rapidly disappear from the circulation. They tend to pass through the circulation of the kidneys to lodge in other organs, such as the liver, the spleen, the lungs and the bone marrow, where they are subsequently destroyed by the tissue cells. This, and not excretion by the kidneys, appears to be the main defense mechanism of the body in cases of blood stream infection. The more specific question as to whether or not a normal kidney can excrete tubercle bacilli has an important epidemiologic aspect and, in a narrower sense, a diagnostic significance. It would seem inadvisable to accept unqualifiedly the dictum of Casper and

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