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April 1957

Bacteremia Due to Diplococcus Pneumoniae Associated with Disease of the Biliary Tract

Author Affiliations

Rochester, Minn.

AMA Arch Intern Med. 1957;99(4):622-627. doi:10.1001/archinte.1957.00260040122012

Bacteremia due to Diplococcus pneumoniae frequently occurs during the course of pneumococcal pneumonia, particularly when the infection is fulminating. Endocarditis, most commonly involving the aortic valve, may complicate pneumococcal pneumonia and is characterized by persistent pneumococcal bacteremia. In pneumococcal meningitis at least 50% of patients have bacteremia due to D. pneumoniae.1 However, invasion of the blood stream by pneumococci in the absence of pneumonia, endocarditis, or meningitis is unusual.

On the addition of whole bile or bile salts, pneumococci autolyze with great rapidity, and clearing of a turbid suspension of organisms occurs within a matter of minutes. The phenomenon of bile solubility is due apparently to activation of autolytic enzymes of the pneumococci by the bile. If the enzymes are first inactivated by heating the suspension of cocci to 65 C for 30 minutes, autolysis no longer takes place when bile is added.2

An infected biliary tree is

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