In 1899 I reported 7 cases1 of pelvic inflammation operated on in the gynecological clinic of the Johns Hopkins Hospital, in which the streptococcus pyogenes was found to be the infecting agent. Since the publication of that article, and during my service in the hospital, 4 additional cases have been operated on in which this micro-organism was found to be the cause of the inflammatory process. Nine of the 11 cases presented certain features which were indicative of the etiology of the infection. The two exceptions were: 1, an infected myoma, and the other an abscess localized to the cul-de-sac of Douglas which had probably been secondarily infected from the intestinal canal. In 6 of these cases the peritoneal cavity was invaded at the operation and 2 patients, where this occurred, died, probably both from the resulting general streptococcic peritonitis. Attention will be called to this in reporting the
MILLER GB. THE STREPTOCOCCUS PYOGENES IN GYNECOLOGICAL DISEASES. JAMA. 1901;XXXVI(20):1379–1382. doi:10.1001/jama.1901.52470200019001d
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