A Note on the Interrelationship of Deficiency Diseases and Resistance to Infection. ∗

Abstract

Summary and Conclusions

1. Our observations in 150 patients from a region of Alabama in which deficiency diseases are endemic show a relationship between these diseases and the resistance to, and presence of, infections with Staphylococcus aureus and Streptococcus hemolyticus. 2. The lesions at the corners of the mouth, characteristic of riboflavin deficiency, contained pure or nearly pure cultures of hemolytic strains of Staphylococcus aureus in 80% of the cases, and in the remaining 20%, Streptococcus hemolyticus predominated. Following the oral or intravenous administration of riboflavin or substances rich in it, the fissures healed rapidly and the organisms were no longer demonstrable. 3. When the bacterial flora of the conjunctival sacs were studied in cases of dietary deficiency disease and associated conjunctivitis, hemolytic strains of Staphylococcus aureus were found to predominate in 14 of the 30 cases. Smears and cultures demonstrated the presence of Corynebacterium xerosis in a pure state in all of the spots of Bitot which occurred in 5 cases. 4. In addition to masses of Vincent's organisms, 64% of the ulcerations of the tongue, gums, or buccal mucosa yielded Streptococcus hemolyticus, and the remaining 36% contained hemolytic strains of Staphylococcus aureus. Following specific therapy with anti-pellagric substances, the bacterial flora of these ulcerations, including the Vincent's organisms, promptly disappeared.

5. A low complement titre exists in acutely deficient patients, and in the subclinical and mild cases the titre is slightly subnormal or normal. Following clinical improvement the complement titre increases. 6. In the whole blood of acutely deficient patients there is a distinct depression in the bactericidal power for Staphylococcus aureus, whereas, only a slight diminution in staphylococcidal power was observed in the blood of subclinical and mild cases of vitamin deficiency.