The Report on Inoculated Tuberculosis Accidentally Caused by Typhoid Vaccin Injection. The Clinical Observation Part II
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この論文は国立情報学研究所の学術雑誌公開支援事業により電子化されました。The cutaneous inoculation tuberculosis was observed on 102 children. As the cause was not clear, they revealed primary tuberculous complex of skin, consisting of the skin lesion on the injection site and the changes of its regional axillary lymph nodes, in consequence of typhoid vaccine injection. The injection was held by three operators, of which a female doctor was an open pulmonary tuberculosis while the others were quite healthy. The affected pupils received the injection from anyone of these three operators. In addition, it seems that there was an equal chance of infection at the end injection as well as at the first. The quantity of the inoculated tuberculous bacilli was naturally unknown. One hundred and two pupils indicated local lesion after the injection, and this number corresponded to 16.1% of the total pupil-number who received the injection there were, among these 102 pupils, some pupils who indicated the change of lymph nodes without skin lesion, or revealed the local change of skin about a year after the injection, or in whom the transitory subcutaneous induration vanished spontaneously as the time passed by. There may have been some that did not reveal local lesion in spite of the simultaneous inoculation of tubercle bacilli at the time of typhoid vaccine injection, but it was very difficult to prove the case exactly. Ninety six pupils had the local changes on the left side, while 6 on the right side. In one-third of the patients, the primary foci of skin were noticed a month after the supposed incculation, but there was one case whose induration was first found about a year after. The incised wound indicated a slight tendency to heal, so it needed one month at the earliest and several months at the latest to recover. Moreover, in some cases the induration or the abscess of the same place appeared again in spite of the former ciatricial healing. The primary foci seemed to be absorbed and disappear in two cases. Subcutaneous metastasis was found in 40 pupils, of which 6 cases showed the metastasis in the centrifugal path way lymph stream. In one case the metastasis appeared inside of the upper arm two years and two months after the typhoid vaccine injection in spite of that the local change had healed and that the axillary lymph nodes had been extirpated. One case showed spontaneous rupture of subcutaneous metastatic induration close to the primary focus 2 years and 4 months after the injection. Swelling of axillary lymph nodes seemed to appear soon after the appearance of primary foci, but there was one case in which the nodular swelling preceded apparently to the primary changes. Most nodes consisted of one to several pieces, each being about the small-finger-tip size, but one case showed a infant-fist-sized swelling of nodes, forming a glandular mass of many pieces. Extirpation of nodes was held on 83 pupils, while on the other hand some cases indicated re-enlargement of nodes to the small-finger-tip or pea-size in spite of that the local lesion completed cicatricial healing and extirpation was once held upon the same place. Re-extirpated cases were 18 in number. Even two years after the typhoid vaccine injection, there was one case in which lymph nodes became suddenly palpable, while they had shrunk spontaneously before hand. In addition, 6 cases received incision or extirpation of their supra-clavicular nodes as they enlarged. In one of these cases, the swelling of supra-clavicular nodes appeared and was incised before that on axillary nodes. Our 102 pupils were all positive tuberculin reactors, revealing apparent erythema and induration, and even double erythema or blister formation. Within 2 and half a year after the typhoid vaccine injection, no case that became anergic was found. As to the result of blood sedimentation rate held in Jan. 1947,we could not pull a conclusion that there were many high-rate owners among the positive reactors in comparison with negative reactors. By X-ray examination of che
- 京都大学の論文
- 1955-12-15
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関連論文
- The Report on Inoculated Tuberculosis Accidentally Caused by Typhoid Vaccin Injection. The Clinical Observation Part II
- The Report on Inoculated Tuberculosis Accidentally Caused by Typhoid Vaccin Injection : The Clinical Observation Part I