In our series of twenty-six patients treated with the special concentrated antistreptococcus serum of the laboratory of the New York State Department of Health there were five patients with generalized or metastatic infection without a clinically recognizable entry portal. These patients were brought under observation in the hospital after invasion of the blood stream had taken place. It is uncertain whether the site of the initial invasion could or could not have been recognized at an earlier time by a competent observer. All five of these patients were children, aged 2 weeks, 27 months, 31 months, 43 months and 5 years, respectively.
REPORT OF CASES
Case 1 (chart 1).
—A. M., a boy, born on April 5, 1933, breast fed, had a high fever fourteen days after birth accompanied by swelling of the left thigh. On admission to the hospital five days later, on April 24, there was a marked