Serum Treatment in a Case of Acute Staphylococcal Septicæmia *Rearranged by Editor.

Clinical notes.?On admission his temperature was 103.4?F., pulse?114, respiration?26 per minute, bowels constipated, tongue furred but moist, throat normal, conjunctivae tinged yellow. Spleen just palpable, abdominal reflex present but sluggish. Heart and lungs normal. No rigidity of neck; Kernig's sign absent. On further examination a small boil was detected on the left elbow; it had burst by itself. Urine.?High coloured, specific gravity?1020, albumin present, sugar present, urobilin present. Total leucocyte count?17,500. Differential count:?Polymorphonuclears?77 per cent, lymphocytes?22 per cent, eosinophils?1 per cent; haemoglobin percentage 85 per cent; red blood cell count?4,120,000. The patient did not sleep the night after admission, his temperature remained high and he appeared extremely ill. On the 9th of August the condition was unchanged. The blood cultures were negative for the enteric group but Staphylococcus albas was grown. Anti-staphylococcal serum was not obtainable locally but the next day a dose of 20 c.cm. was procured and injected intravenously. The leucocyte count was now 20,000 and the man was in a serious state with a dry cracked tongue. On the evening of the next day (11th) another 30 c.cm. of anti-staphylococcal serum arrived and was given immediately. The next morning there was great improvement. The temperature dropped to subnormal but the blood was found still to contain staphylococci. The following day the temperature again rose, the urine still contained albumin and urobilin and a few red cells were present. He was given another 30 c.cm. of serum.