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72
Two deaths occurred from scarlet fever, one was of a woman
who had been confined two days previous to the onset of the attack
of scarlet fever. Cultures showed haemolytic streptococci to be
present in both her throat and uterus. She improved for a time,
but developed peritonitis which became generalised; a laparotomy
was performed by Mr. Everard Williams to relieve the condition.
The result shows that puerperal scarlet fever, now fortunately so
rare, may still be as fatal a condition as ever it was.
The second death from scarlet fever was in a child of three
years who developed broncho-pneumonia and died within five days
of admission.
Scarlet fever has been on the whole of a more severe type and
has shown a curious tendency, when it attacked the middle ear,
to involve the mastoid bone. 9 per cent, of the cases of scarlet
fever developed middle ear disease and six cases of mastoiditis
occurred. All of these were operated on by Mr. Stoker, and made
a satisfactory recovery. In the year previous, 5 per cent, of the
cases developed middle ear disease, and no case of mastoiditis
occurred.
Enteric Fever.—16 cases were admitted, 13 of these were cases
of Paratyphoid infection, 9 of these were mild cases and made an
uneventful recovery; four were more severe, two being complicated
by intestinal haemorrhage, one by pyelonephritis, and the fourth
by lobar pneumonia. Two of the 16 were clinically cases of enteric
fever but gave a negative Widal reaction. The remaining one case
was due to an infection with B. Typhosus, the patient, a woman
of 56, made an excellent recovery, although the illness was complicated
by a typhoid pneumonia.
Puerperal Cases.—Three patients were transferred from the
Maternity Home, suffering from a puerperal pyelonephritis. All
made an excellent recovery. One case which had been admitted
to the Maternity Home and found on admission to have a perineal
abscess, was transferred. She made a good recovery, but had a
recto-vaginal fistula which will subsequently require operation.
One case of puerperal fever was admitted from the district. It was
a mild case and recovered after a slight attack of phlebitis.