The presence of the hemolytic streptococcus in the blood preceding and during the eruptive stage of a case of hemorrhagic smallpox led us to inquire whether this was a common finding in this form of smallpox. A search through the literature failed to give any information on this point. The close association of the streptococcus with variola is well known. In forty necropsies, practically all of which were in severe cases of smallpox, Perkins and Pay1 found streptococci in the heart's blood and viscera of thirty-eight, or in 95 per cent. of the cases. Of these forty cases three were of the purpuric type, nine of the so-called secondary hemorrhagic type (variola hemorrhagica pustulosa), twenty-four of the confluent type, one discrete, two varioloid and one desiccating. The streptococcus was present in all of the cases except one purpuric and one varioloid case. These same workers examined the blood of twenty
KEMPTON RM, PARSONS JP. REPORT OF A CASE OF HEMORRHAGIC SMALLPOX: A CONSIDERATION OF THE RÔLE PLAYED BY THE HEMOLYTIC STREPTOCOCCUS. Arch Intern Med (Chic). 1920;26(5):594–600. doi:10.1001/archinte.1920.00100050087006
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