138
A. SARAGEA ET AI,.
B. Methods
1. Swabbing of patients and carriers
Swabbing should be carried out in the morning before breakfast, before
any gargling with antiseptics and or treatment with antibiotics. If antibiotic treatment has been started, the laboratory should be informed.
The pathologic materials to be examined in patients are the following:
In the case of tonsillitis or faucial diphtheria-three swabs collected from
the tonsillar exudates and one from the nasal secretions.
In the case of diphtheric rhinorrhoea-three swabs collected from nasal
secretions and one from the pharynx or tonsils.
In the case qf any other possible location (skin ulcers, conjunctivitis,
otitis, burns, surgical wounds, vu1vovaginitis)-three swabs should be
collected from the site of infection, and two others from the throat and nose,
even if the patient has no nasopharyngeal symptoms.
Reasons for the number of swabs recommended-from the first swab a
smear is prepared. This will serve to establish the differential diagnosis
from Plaut Vincent’s angina in faucial diphtheria. However, even a skilled
bacteriologist can never more than presume the presence of diphtheria
bacilli in a direct smear.
I n order not to lose time the second swab is streaked on selective and
differential solid media. In order to avoid failure of growth, the third
swab is immersed in a liquid enrichment medium and then streaked on
solid selective media.
Specimens of exudates from both nose and pharynx, in extrapharyngeal
diphtheria are taken to establish the relationships between these forms and
cases of rhinopharyngeal diphtheria.
2. In contacts and healthy carriers
According to a well-designed field experiment (Saragea et al., 1965) there
are several basic principles that must be applied in checking contacts and/or
healthy carriers, with a view to limiting an outbreak of diphtheria as
quickly as possible.
Two swabs (Figs 37, 38), one from the pharyngeal and the other from
the nasal exudate, are always collected from every individual assumed to be
in direct or indirect contact with infected patients and from supposed
healthy carriers. Swabbing is performed by thoroughly swabbing both
tonsils, and both nostrils.
A large number of contacts are swabbed in order to determine the
extension of the infected area.
The whole community (ix. all the individuals to be swabbed) is simultaneously checked for carriage, in order to discover all healthy carriers
and/or contacts as soon as possible, and to be able to apply simultaneously
A. SARAGEA ET AI,.
B. Methods
1. Swabbing of patients and carriers
Swabbing should be carried out in the morning before breakfast, before
any gargling with antiseptics and or treatment with antibiotics. If antibiotic treatment has been started, the laboratory should be informed.
The pathologic materials to be examined in patients are the following:
In the case of tonsillitis or faucial diphtheria-three swabs collected from
the tonsillar exudates and one from the nasal secretions.
In the case of diphtheric rhinorrhoea-three swabs collected from nasal
secretions and one from the pharynx or tonsils.
In the case qf any other possible location (skin ulcers, conjunctivitis,
otitis, burns, surgical wounds, vu1vovaginitis)-three swabs should be
collected from the site of infection, and two others from the throat and nose,
even if the patient has no nasopharyngeal symptoms.
Reasons for the number of swabs recommended-from the first swab a
smear is prepared. This will serve to establish the differential diagnosis
from Plaut Vincent’s angina in faucial diphtheria. However, even a skilled
bacteriologist can never more than presume the presence of diphtheria
bacilli in a direct smear.
I n order not to lose time the second swab is streaked on selective and
differential solid media. In order to avoid failure of growth, the third
swab is immersed in a liquid enrichment medium and then streaked on
solid selective media.
Specimens of exudates from both nose and pharynx, in extrapharyngeal
diphtheria are taken to establish the relationships between these forms and
cases of rhinopharyngeal diphtheria.
2. In contacts and healthy carriers
According to a well-designed field experiment (Saragea et al., 1965) there
are several basic principles that must be applied in checking contacts and/or
healthy carriers, with a view to limiting an outbreak of diphtheria as
quickly as possible.
Two swabs (Figs 37, 38), one from the pharyngeal and the other from
the nasal exudate, are always collected from every individual assumed to be
in direct or indirect contact with infected patients and from supposed
healthy carriers. Swabbing is performed by thoroughly swabbing both
tonsils, and both nostrils.
A large number of contacts are swabbed in order to determine the
extension of the infected area.
The whole community (ix. all the individuals to be swabbed) is simultaneously checked for carriage, in order to discover all healthy carriers
and/or contacts as soon as possible, and to be able to apply simultaneously