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The etiologic relationship between diphtheria and the diphtheria bacillus has been established beyond cavil. It may seem a platitude to assert that the disease known as human diphtheria is the reaction of the body to the toxin of the diphtheria bacillus. The unfortunate annual succession of tragedies witnessed at the Willard Parker Hospital, traceable to lack of clear thinking on this point, have forced us to emphasize the fact that the presence of diphtheria organisms in the throat is not synonymous with diphtheria, and that the failure to find diphtheria organisms in culture tubes inoculated from swabs passed over the mucous membranes of the throat does not exclude the presence of diphtheria. In the interests of clear medical thinking, we wish to emphasize the fallacies that may result from the throat culture diagnosis of diphtheria, and the dangers consequent upon delay in making the diagnosis from a laboratory report instead
BULLOWA JGM, HARDMAN RC, LITCHFIELD HR. MENACE OF THE DIAGNOSTIC THROAT CULTURE IN DIPHTHERIA. JAMA. 1923;80(4):240–242. doi:10.1001/jama.1923.02640310020006
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