FURTHER STUDIES ON RECURRENCES IN PNEUMOCOCCIC PNEUMONIA WITH SPECIAL REFERENCE TO THE EFFECT OF SPECIFIC TREATMENT

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Abstract
A study of 168 patients with 191 recurrent attacks of pneumococcic pneumonia is presented. The initial and subsequent attacks did not differ significantly in the character or site of the pulmonary lesions, or in the distribution of the types of pneumococci involved. There was no increased tendency for recurrent attacks to be bilateral. Chronic pulmonary disease was a predisposing factor m only 15% of the patients. In such patients, the attacks tended to recur at shorter intervals. The duration of the recurrent attacks was the same or shorter than the original infections. The frequency with which the same type was present in successive attacks was inversely proportional to the length of the interval between attacks. Type III was more frequently present in successive attacks than any other type. Successive attacks with the same type of pneumococcus were not more frequent in patients with chronic pulmonary disease than in other patients. Recurrences were not more frequent in patients treated with sulfonamide drugs in the first attack than in those treated with serum or in those treated nonspecifically, but there was a tendency in the drug-treated cases for 2d attacks to occur with the same type and at shorter intervals. There is some indirect evidence that early recurrences with the same type of pneumococcus are associated with a persistence of the carrier state. There is no correlation between the antibody response and the tendency of pneumonia to recur.
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