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June 25, 1938

Current Comment

JAMA. 1938;110(26):2158-2159. doi:10.1001/jama.1938.02790260032015

PNEUMOCOCCUS POLYSACCHARIDE IN URINE  Urinary excretion of the specific capsular substances formed by pneumococci is of little or no diagnostic value, owing to the inconstant excretion of this substance during the early stages of lobar pneumonia. Cruickshank1 of the University and Royal Infirmary, Glasgow, Scotland, however, believes that detection of the type-specific polysaccharide in the urine is a valuable prognostic index, the mortality among patients with "pneumococcosuria" being twenty times greater than that of pneumonia patients whose urine remains free from this polysaccharide during the course of the disease. Cruickshank's conclusions were drawn from his study of about 200 patients with pneumococcic infections, 184 of whom were suffering from lobar pneumonia. Type polysaccharides were estimated quantitatively in the urines of these patients by means of high titer type-specific antiserums. The serum used in most of his tests was capable of detecting homologous pneumococcus polysaccharide in dilutions as high as