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May 2, 1936


JAMA. 1936;106(18):1588. doi:10.1001/jama.1936.02770180062025

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To the Editor:—  A boy, aged 6, was seen February 23, at which time a diagnosis of scarlet fever was made from the typical history and appearances. The temperature was 102 F., the throat was red with markedly enlarged tonsils, and a bright rash was present. February 28 a follicular tonsillitis developed: the temperature ranged between 101 and 103 F. March 2 the follicles became confluent to form a membrane, which covered both tonsils. The membrane appeared like the usual streptococcic membrane—bright yellow. It did not appear or behave like a diphtheritic membrane. A culture, however, was taken after great effort, the patient being very uncooperative. This culture came back unsatisfactory. A second culture taken came back positive for diphtheria bacilli, which were subsequently shown to be virulent by a virulence test. Antitoxin was then administered, 10,000 units followed in twenty-four hours by 5,000 more. It was given intramuscularly. No

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