Suppurative Cholecystitis with Cholelithiasis in a Human “Carrier” of the Bacillus enteritidis of Gaertner

Abstract

In a case of suppurative cholecystitis with cholelithiasis a bacillus was isolated from the pus, gall bladder, and stools which has the morphological, biological and cultural characters of B. enteritidis Gaertner. This bacillus is pathogenic for the rat, rabbit and guinea-pig, and gives rise to the characteristic lesions produced by the Gaertner bacillus. The serum of the patient agglutinated the three strains of bacilli isolated from the above mentioned sources and the original Gaertner strain in a dilution of 1 in 40. A serum, prepared by injecting B. enteritidis Gaertner (original strain) into a rabbit, agglutinated the three strains isolated from the case and the homologous bacillus in almost the same dilutions.A serum prepared from any of the three bacilli agglutinates the homologous organism, the other two strains and the original Gaertner bacillus in almost the same titre. The sera homologous to allied organisms do not agglutinate these bacilli. Absorption tests confirm these results and prove that the bacilli isolated are identical with the Gaertner bacillus.The chief points of interest in the case are that:1. It forms a link in the chain of evidence showing that as in the case of the paratyphoid bacillus the B. enteritidis Gaertner may give rise, not only to the more acute toxic from of poisoning, but also to a sub-acute paratyphoid type of the disease.2. It establishes the association of B. enteritidis Gaertner with suppurative cholecystitis and with cholelithiasis.3. It proves that this bacillus may have its habitat in the gall bladder and be shed out at intervals into the faeces, in a manner exactly analogous to what occurs in the case of typhoid and paratyphiod infections.