Three fatal cases of Bacillus pyocyaneus infection observed at Mount Sinai Hospital of Cleveland presented characteristic features, including gangrenous and less severe lesions of the skin, most advanced in the anal, rectal or genital areas; general intoxication with profound prostration and, at autopsy, hemorrhagic and necrotic lesions in the skin and viscera, associated with massive local bacterial colonization. One of these cases, which presented agranulocytosis, terminated eighteen days after the onset of symptoms in a previously healthy child.
B. pyocyaneus infection, although not of common occurrence, is perhaps less rare than is generally supposed. Clinically it may be confused with a number of skin diseases, including pellagra and lupus erythematosus disseminatus. It must be differentiated from aleukemic leukemia, the purpuras and other diseases. Some progress toward specific therapy has been reported by Wassermann,1 and it is possible that further studies will reveal methods of preparing potent bactericidal and antitoxic
KLINE BS, MASCHKE AS. THREE FATAL CASES OF BACILLUS PYOCYANEUS INFECTION. JAMA. 1932;98(7):528–532. doi:10.1001/jama.1932.02730330010003
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