Fibrinolysis in Gram-Negative Bacilli

The bacteriology of peritonitis complicating appendicitis has been carefully studied with varying emphasis on the role of each of the more commonly found organisms. Steinberg (1944) and others (Rademaker, 1933; Altemeier, 1938) have emphasized the role of the gram-negative bacilli in peritonitis. Bower and his associates (1928, 1938) have shown the importance of the clostridia, particu-larly Clostridium welchii, both experimentally and clinically, whereas Meleney and his associates (1931, 1932) have re-emphasized the importance of gram-negative bacilli and have shown the importance of synergism of two or more organisms in the mortality associated with peritonitis. Recently interest has been aroused in the role of fibrinolysis in experimental appendiceal peritonitis by the observations of Kay and Lockwood (1947), who have found little correlation between mortality and the initial flora in the appendix but have emphasized rather the prognostic importance of the fibri-nolytic and antifibrinolytic activity of the plasna. Increased fibrinolytic activity before onset and during the disease was of unfavorable prognosis.