Since my preliminary publication1 on differential jugular blood cultures, I have used the procedure in eleven more cases, making a total of fifteen cases so treated. The practical value of the procedure is beginning to be more clearly defined. Perhaps of more importance than its diagnostic use is the new light which the method throws on the mechanism of blood stream infection in sinus thrombosis.
It will be remembered that the principle of the procedure consists in aspirating blood simultaneously from the two internal jugular veins, carefully plating it out in petri dishes of nutrient agar, and comparing the number of colonies of bacteria per cubic centimeter of blood obtained from the two sides.2 In a case of otitic infection, a very marked difference in the number of micro-organisms in the two sides is regarded as evidence of thrombus on one lateral sinus or the other.
OTTENBERG R. DIFFERENTIAL JUGULAR BLOOD CULTURES IN SINUS THROMBOSIS. JAMA. 1928;90(20):1602-1604. doi:10.1001/jama.1928.02690470008002