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presented at the Second Annual Veterans Administration Conference on Hospital Infection Control, Minneapolis, Minn., March 31 to April 1, 1977. Reprint requests: Flor 1. Tecson-Tumang, M.D., Infectious Disease Section, Medical Service, Veterans Administration Medical Center, East Orange, NJ 07019 120 days. On the seventh hospital day, a nurse charted an observation that the patient complained ..the IV hurt my arm" and that he subsequently pulled the IV line out. On day 8, the patient was noted to be nervous and tremulous. On day 9, it was noted that he was disoriented, had neck pain on motion, and was febrile (rectal temperature as high as 104.4° F). At this point infectious disease consultation was sought. When seen by us, the patient had frank signs of meningitis. There was no evidence of phlebitis and no skin lesions were observed. No heart murmur was heard. A spinal tap revealed turbid and xanthochromic cerebrospinal fluid with a WBC count of 2800/mm3 , 98% of which were polymorphonuclear cells and 2% lymphocytes. The protein was 340.2 mg/dl and sugar 46 mg/dl (blood sugar 135 mg/dl). A Gram stain of the cerebrospinal fluid was read as negative and ampicillin, 2 gm every 4 hours, was started. However, cultures of both blood and cerebrospinal fluid the next day revealed coagulase-positive Staphylococcus aureus resistant to penicillin but sensitive to cephalothin, gentamicin, erythromycin, lincomycin, tetracycline, and methicillin. Methicillin, 2 gm IV every 4 hours, was started and ampicillin was discontinued. On the twelfth hospital day, a repeat spinal tap revealed bloody and partially clotted spinal fluid with a red blood cell (RBe) count of 405/mm3 , WBC count 3/mm3 with two polymorphonuclear cells and one lymphocyte, sugar 115 mg/ dl (blood sugar 260 mg/ dl), and protein 230 mg/dl. Staphylococcus aureus was

During the first week of March 1974, a hospitalized patient being evaluated for hyperproteinemia and hypertension experienced fever, chills, and myalgia and showed pulmonary signs consistent with diffuse pneumonia. Subsequently, the findings from serologic tests confirmed that the patient had viral influenza. Seven other compromised hosts on the same ward developed symptoms of pneumonic influenza, and serologic data on three of the seven confirmed influenza A2. Additionally, a previously healthy young adult admitted with acute respiratory distress died of nonbacterial complications and was shown to have community-acquired influenza. The unusual features of the epidemic were the intrahospital localization of the epidemic in compromised hosts, the high rate of pneumonic complications, the low rate of secondary bacterial infection, and the severity of the viral pneumonia in the community-acquired case.

Excerpt To the editor: We have recently encountered a patient with the acquired immunodeficiency syndrome and disseminated infection withMycobacterium xenopi. This case appears unique becauseM. xen...