STREPTOCOCCIC INFECTION OF THE LUNGS FROM THE PARANASAL SINUSES: AN EXPERIMENTAL STUDY

The relation of certain types of pulmonary infection to drainage from the paranasal sinuses has been emphasized by Mullin1in a series of papers. The various routes by which such drainage may reach the lungs have been discussed by Mullin,1Lawson2and others. More recently the results of experimental studies3have shown clearly that probably the most important pathway is a route combining the lymphatic and the blood vessels from the sinus membranes to the pulmonary capillary bed via the right side of the heart. These conclusions were reached as a result of injecting trypan blue into the sinuses and related regions under conditions which precluded the tracheal pathway to the lungs. Later, at various intervals, the trypan blue was found in phagocytes in the lungs and at various points along the route indicated. On the basis of these results, experiments were undertaken to determine if cultures of steptococci introduced