Tuberculosis of the larynx.

Abstract

MemorandaB 991 100 ml.conjugated bilirubin) ; serum calcium 9.2 mg./100 ml. ; serum electrolytes normal; plasma proteins 8.6 g./100 ml.(albumin 3.1 g., globulin 5.5 g.).Plasma protein electrophoresis showed the increase in the globulin to be diffusely distributed in the gamma-globulin range.Blood culture negative; Coombs test negative.Examination of the urine showed 50 white cells per high-power field.A significant growth of Escherichia coli was isolated.Radiological examination: hands and long bones revealed nothing abnormal; skull vault showed slight thickening, spine showed osteoporosis ; chest had enlarged hilar and paratracheal lymph nodes.Intravenous Urography.-Therenal outlines were well seen and were normal in size and shape.No evidence of intrarenal calcifica- tion was seen.There was good bilateral excretion of contrast medium from the kidneys.Caliceal clubbing was noted in the upper and middle right groups of calices, and medullary cavities were seen arising from their papillary ends.On the left side smaller cavities were seen arising from the upper and lower calices.A long ragged cavity was seen in the middle calix, extending into the renal medulla.The appearances were reported as consistent with moderately advanced renal papillary necrosis (Special Plate, Figs. 1 and2).