The following case presents so many clinical features of interest that a full report seems justifiable:
—When I first saw this child the following history was obtained from the family physician: A girl, aged 11, previously healthy, began, on the third or fourth day, after the onset of a well-developed scarlatinal eruption, to show signs of involvement of the nasal, pharyngeal and faucial mucous membranes. Several days later the patient began to complain of pain in her left ear and on the following day both ears were discharging pus.
—There was marked involvement of the mucous membrane of the upper respiratory tract, especially of the nose. The turbinates were swollen, blocking the nares. They were bathed in a yellowish pus, which had caused an excoriation of the nostrils and skin beneath. A stringy muco-pus could also be seen on the posterior pharyngeal wall. Both faucial tonsils were enlarged