Acute Primary Klebsiella Pneumonia

The management of lobar pneumonia due to Klebsiella pneumoniae (Friedländer's bacillus) continues to offer a real challenge to the clinician. As late as 1945 reports1indicated a mortality of 51 to 97 per cent. This is in contrast to the dramatic success in the treatment of the other bacterial pneumonias with the antibiotics. The incidence of lobar pneumonia caused by the gram-negative bacillus of the Friedländer group, Klebsiella pneumoniae, is variously reported as from 0.5 to 1.6 per cent of all cases of pneumonia; the disease may occur in all seasons. Although Hyde and Hyde1awere of the opinion that the sulfonamide drugs given early were of some benefit against the disease, their general conclusion was that the over-all value was questionable. Anderson2reported that K. pneumoniae is not susceptible to penicillin in vitro, and clinical experience substantiates this observation. In 1945 Heilman3reported in vitro