Infectious hepatitis complicated by secondary invasion with Salmonella.

Information has been obtained from the experimental transmission of infectious hepatitis to human volunteers (1 to 7) to indicate that the icterogenic agent, which is known to be in the blood and stools of patients during active stages of the disease, is filtrable and may be transmitted to human volunteers by feeding or by parenteral inoculation of infectious material. Although the exact nature of this icterogenic agent is not yet defined, it is believed to be a virus (6, 7). These facts are in agreement with the failure to identify any specific bacterial organism consistently with this disease (8 to 11). In view of this recent knowledge, the purpose of this paper is: (1) to point out the extensive and controversial experience of World War I in which the frequent association of infectious hepatitis and certain strains of salmonellae was observed; (2) to report in detail the occurrence of secondary invasion with S. choleraesuis in 2 human volunteers with experimental virus-induced hepatitis. We believe that this finding, limited as it is to a small number of patients, points the way to an explanation of the controversy over the etiology of this disease which existed 25 years ago.