C. diphtheriae is an unusual causative organism in subacute bacterial endocarditis as only 17 cases have been recorded and none of these has survived. The 8 year old girl in this report is the first patient to have recovered. This child had two positive blood cultures for virulent intermedius strain of C. diphtheriae which was sensitive to 0.05 u./ml. of penicillin and to 3.0 u/ml. of streptomycin. The patient received penicillin therapy for one month and responded poorly. When streptomycin was also administered there was dramatic improvement. This clinical experiment tends to substantiate Hewitt's work in animals which demonstrates that streptomycin is much more effective than penicillin in saving guinea pigs injected with C. diphtheriae. In vitro tests with the organism isolated in this patient revealed neither evidence of synergism nor antagonism when studied with combinations of penicillin, streptomycin, sodium sulfadiazine and aureomycin. It is suggested in future cases that a combination of penicillin and streptomycin be used and that sensitivity tests be performed on the organism so that the physician may determine the proper dosage of antibiotic.
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机译：白喉衣原体在亚急性细菌性心内膜炎中是一种异常的致病菌，因为仅记录了17例，但这些都没有存活。该报告中的8岁女孩是第一位康复的患者。这个孩子对白喉衣原体的中间强毒株有两种阳性血液培养，对0.05 u./ml敏感。青霉素和3.0 u / ml。链霉素。患者接受青霉素治疗一个月，反应较差。当还施用链霉素时，有显着改善。该临床实验倾向于证实休伊特在动物中的工作，这表明链霉素在挽救注射白喉衣原体的豚鼠中比青霉素更有效。用青霉素，链霉素，磺胺嘧啶钠和金霉素联合研究时，用该患者体内分离出的微生物进行的体外试验未显示协同作用或拮抗作用。建议在将来的情况下使用青霉素和链霉素的组合，并对生物体进行敏感性测试，以便医生确定抗生素的正确剂量。
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