STUDIES OF GONOCOCCAL INFECTION. III. A COMPARISON OF THE BACTERICIDAL PROPERTIES OF THE SYNOVIAL FLUID AND BLOOD IN GONOCOCCAL ARTHRITIS

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Abstract
In a comparative study of the bactericidal activity of the blood and synovial fluid in gonococcal arthritis and in arthritis due to other causes, it was found that synovial fluid in non-gonococcal arthritis is not bactericidal for the gonococcus. This is due to the absence of demonstrable antibodies against the gonococcus, and not due to the absence of complement. Synovial fluids which are infected with gonococci fail to show active bactericidal antibodies. The blood from such individuals is often actively bactericidal for the homologous organism. When the synovial fluid which is obtained from cases of gonococcal arthritis is sterile, it is actively bactericidal for the homologous strain of gonococcus. This is due to the presence of antibody and complement. Heating synovial fluid at 56[degree]C for 30 min. destroys its bactericidal activity. This is dependent upon inactivation of complement and not due to the destruction of antibody. When the bactericidal activity of synovial fluid and whole blood is compared in the same patient, using the homologous organism, it was found that when the synovial fluid is infected, the bactericidal content of the blood is higher than the synovial fluid. When the synovial fluid is sterile the bactericidal content is the same or slightly less than the blood.