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To the Editor:
—In The Journal, April 16, is a case report by Dr. R. S. Spray of diphtheria and Vincent's angina running concurrently.To me the evidence is far from complete. Frequently there are cases of Vincent's infection in which the membrane closely simulates that in diphtheria. The fact that it cleared up following the administration of antitoxin is not conclusive; the improvement might have been coincidental, as cases of Vincent's angina with membrane formation sometimes improve without any specific treatment.The presence of a positive culture of the diphtheria bacillus is not conclusive evidence. The strain might be a nonvirulent one. Dr. Spray states that a virulence test is going to be made. I might suggest here that, if he uses the Force-Beattie technic, the culture would not have to be purified to make the test. And even if the strain of the diphtheria bacilli is a virulent
Robinson JW. COINCIDENT DIPHTHERIA AND VINCENT'S ANGINA. JAMA. 1927;88(20):1585. doi:10.1001/jama.1927.02680460055025
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