THE DIAGNOSTIC VALUE OF SMEARS FROM PURPURIC LESIONS OF THE SKIN IN MENINGOCOCCIC DISEASE

Abstract

My purpose in this communication is to describe an aid in the diagnosis of meningococcic disease. This aid, the study of smears from purpuric skin lesions, while not new, is not widely used nor fully appreciated. It has particular application in outbreaks among military personnel in view of the high incidence of cutaneous lesions among them. In January 1943, during an outbreak of meningococcic disease, a patient was admitted to the infectious disease ward of this hospital in coma. She presented fever, leukocytosis, meningeal signs and a petechial type of cutaneous lesion over the extremities and axillary region. The cerebrospinal fluid was cloudy and contained neutrophils but no bacteria. Cultures of cerebrospinal fluid and blood were sterile. The patient was treated with sulfadiazine and made an uneventful recovery. In reviewing her case we were surprised to find that the organism believed to be responsible for her illness, namely the meningococcus,