A skin reaction to pneumotoxin

Abstract

The work reported is a part of the studies on the properties of pneumotoxin and its probable role in the pathology of lobar pneumonia. Previous investigators (Clough, Weil, Steinfield and Kolmer) working with dried, autolyzed or heat-killed pneumococci failed to elicit any constant, specific reaction in cases of lobar pneumonia. The present authors used the endocellular hemolytic toxin of the pneumococcus freshly prepared for each test by dissolving the washed living organisms (Type I) in solutions of sodium choleate. Guinea pigs previously sensitized with sublethal doses of pneumotoxin or with the serum or lung exudate of dogs suffering from experimental lobar pneumonia, reacted to the intracutaneous injection of 0.1 c.c. of the toxin by a local erythema and hemorrhagic edema in the subcutaneous tissue overlying the muscle. The skin reaction to heat-killed pneumococci was negative in most of these animals and when positive, was of a suppurative type, marked by less edema and more leucocytosis. Control animals gave uniformly negative results.

Among human adult cases of lobar pneumonia the reaction (which was characterized by a local edema and erythema) was elicited as early as the fifth and as late as the thirteenth day of the disease (two days before and six days after the crisis, respectively). In children it was demonstrable about the same time, but was negative immediately or one or two days after the crisis. Patients recovering by lysis reacted as late as the thirty-second day. In general, the test was positive in all active cases, that is, throughout the toxemia. Cases earlier than the fifth day of the disease were not available. Control patients, suffering with bronchopneumonia or with acute or chronic infections not of pneumococcic origin, as well as healthy adults and children did not react.