Chronic Infectional Edema

Ten years after Fehleisen1isolated the streptococcus from the skin lesions of erysipelas, Sabouraud2obtained cultures of streptococcus from patients with recurrent erysipelas and elephantiasis. Subsequent pathologic studies of the diseased tissues convinced both Sabouraud and Unna3that the edema and fibrosis which they found in the microscopic sections were not the result of circumscribed obstruction to the lymphatics, as in filarial elephantiasis, but to local changes in the tissues. Although they disagreed in some particulars regarding the mechanism underlying the pathogenesis of the edema and fibrosis, they agreed that repeated streptococcic infections which kept the cells bathed in the products of bacterial disintegration that were not adequately drained away were responsible for the pathologic condition. While Sabouraud attributed the hypertrophy solely to streptococcic infection, instances of chronic or recurrent infections with staphylococcus4as well as streptococcus5causing similar edema and fibrosis have been reported