Staphylococci in the Newborn

Abstract

B 3. Haemoglobinuria.-Thisapparently had all the clinical features of haemoglobinuria of exertion (Whitby and Britton, 1946).Its aet-iology is obscure.Regarding the part played by exertion in these cases, all that can be said is that the patients were ambulant the previous day, but not to any great extent.Blood urea remained unraised and urine did not at any time before the onset of haemoglobinuria show evidence of nephritis or necrosing nephrosis due to toxic action of lead, or of haemoglobinurqc ne hrosis following haemoglobinuria.The possibility that it was caused by an acute haemolytic crisis due to lead cannot be ruled out.It appears that the blood was almost completely cleared 9f its oxyhaemoglobin content when a sample was taken for examination, whereas the urine collected at the same time was that which had accumulated in the bladder for at least four hours.Subsequent samples of urine had been markedly and progressively clear.The amount of blood destroyed by haemolysis seems to have been small, as shown by the red-cell counts before and after the haemolysis.The first sample of haemoglobinuric urine had been passed from seven to nine hours before the collection of venous blood.Haemolysis had no doubt taken place earlier than this.During this period the haemoglobin in the blood could have been easily cleared by the kidneys.Hence the apparent similarity to haemoglobinuria of exertion. 4. Erythrocyzosis.-Thisaccompanied the symptoms of acute Parkinsonism very closely.In all probability it was of the same nature as polycythaemia described in encephalitis lethargica and Huntington's chorea by Moehlig and Bates (1933).5. Pallor.-This was not a feature of any of the cases recorded by Cassells and Dodds.Its presence in my two cases was a pointer to its causation by lead. SummaryAcute Parkinsonism, haemoglobinuria, abdominal pain simu- lating appendicitis, erythrocytosis, and pallor are recorded in two petrol-tank cleaners.These symptoms were in addition to the usual effects of exposure to petrol vapour and lead tetra.ethyl.