Bacillus pyocyaneus infections; a review, report of cases and discussion of newer therapy including streptomycin.

Abstract 1.1. The literature on the various types of infection due to B. pyocyaneus is reviewed and ten cases are described in detail, including one case of endocarditis and one of pneumonia. 2.2. Local infections due to B. pyocyaneus are frequent and usually benign. The most common sites are superficial surgical wounds, the skin and the lower urinary tract. The organism is often seen as a secondary invader in chronic otitis media. Corneal ulcers are rare but important because of the tendency when untreated to progress to panophthalmitis. 3.3. The clinical picture in sepsis due to this organism is summarized from the literature and exemplified by four typical cases. Important features include the high mortality rate, tendency to occur in infants and children and in debilitated adults, and frequent occurrence of ulcerating gangrenous lesions in the skin ("ecthyma gangrenosum") and throughout the gastrointestinal tract. 4.4. In treatment the sulfonamides and streptomycin are the agents of choice. Streptomycin appears to be as good as, and in some instances, better than the sulfonamides, particularly in urinary tract infections. Factors which seem to be important in the lack of success of treatment with streptomycin in sepsis are the frequent presence of other serious disease producing general debility and occasional rapid development by the infecting organism of resistance to the chemotherapeutic agent. For local infections applications of 1 to 2 per cent acetic acid have been known to be efficacious for many years. Recently good results have been obtained in such conditions by the use of phenoxetol and of a solution containing 10 per cent urethane and 1 per cent sulfanilamide.