To the Editor.—I am somewhat disturbed or mildly horrified by the paper "Hypofibrinogemia and Thrombocytopenia with Meningococcemia" (Amer J Dis Child113:494, 1967). It is beside the point that I do not subscribe to the theory that meningococcemia and gram-negative bacterial sepsis are of identical nature. My objection is to the final paragraph of the summary in the statement: "This case also demonstrates the value of gram stains applied to smear of the aspirate of the ecchymotic lesions in illnesses characterized by purpura. A rapid diagnosis of meningococcemia can thus be made if the smear shows gram negative diplococci."
The very sad comment on this summary is the fact that this child was not very ill eight hours prior to admission and was treated symptomatically; one hour after admission she developed purpura and petechiae; on admission, she was alert and not in shock, but one hour later she