Research Article| Volume 17, ISSUE 6, P573-582, March 1932

The bacteriology of the nose and throat

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      From the foregoing paragraphs, it is evident that many bacterial species are to be found in the nasal passages and throat, and that the same, or apparently the same species occur on both the healthy and diseased mucous membrane. Therefore it is difficult, in the absence of a definite lesion, to appraise satisfactorily the clinical significance of many of the species encountered in a bacteriologic examination. This is especially true of the streptococci, whether green, indifferent or hemolytic, the pneumococci, staphylococci, gram-negative cocci and hemoglobinophilic bacilli. If we consider the hemolytic streptococci as an example, we must remember that they comprise a large group of many strains which differ greatly in their pathogenicity and virulence, and that while certain strains may give rise to scarlet fever, or to septic sore throat, others may be innocuous. The finding of hemolytic streptococci, therefore, is not necessarily significant, but the finding of a particular strain may be of great significance. Unfortunately the demonstration of a particular pathogenic strain is not always easy and is usually impractical in routine examinations. The rôle of the anaerobic bacteria as incitants of colds and influenza is unknown; they would appear to be part of the normal flora and of little if any pathogenicity, but additional experimental evidence may change our views. The recent work of Dochez,67 confirming the earlier work of Kruse68 and Foster,69, 70 has again directed our attention to the probability that a filterable virus is the primary cause of certain respiratory infections, preparing the way for the secondary complications which may be brought about by many of the common bacteria harbored in the upper respiratory tract. We are probably correct in believing that in the presence of a definite lesion the finding of an organism of known or potential pathogenicity is clinically significant; that in the absence of a lesion it denotes a carrier, but beyond this our present lack of knowledge does not justify definite interpretations.
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