Severe streptococcic infections are known to follow pneumococcic pneumonia with considerable frequency. Soon after the differentiation between pneumococci and streptococci and the recognition of the former as the principal etiologic agent in lobar pneumonia, Jaccoud1 demonstrated that streptococci may be found as secondary invaders, causing purulent complications. Netter2 mentions streptococcic septicemia as a fatal complication during convalescence from lobar pneumonia. Cole and MacCallum,3 Cumming, Spruit and Aten4 and Clendening5 found streptococcic infections to be relatively frequent during convalescence from lobar pneumonia in the army base hospitals. More recently, Avery, Chickering, Cole and Dochez,6 Johnston and Morgan,7 Cole,8 Sutliff and Finland9 and others have noted occasional cases in which the hemolytic streptococcus was the cause of fatal complications during lobar pneumonia.
The pathologic changes in the lungs of patients from whom the pneumococcus was recovered during the acute stage of lobar pneumonia