Sir.—Dr. Welch's critical comments are understandable. My article was meant to be a report of an interesting observation and to call attention to the frequent association of urinary tract infection and pinworm infestation in girls. I believe one is justified in making a diagnosis of urinary tract infection without a urine culture. To prove the speculation that the pinworm carries fecal contamination into the urinary bladder would require documentation of catheterized urine cultures as Dr. Welch suggests. Finding pinworm ova in these specimens would be significant.
All patients had a variety of symptoms that would make one suspect urinary tract infection. The diagnosis was made on my personal examination of a properly collected urine specimen. All specimens were examined unspun and a diagnosis of infection was made if the low-power field was loaded with pus cells. Catheterized urine for culture was taken only from those patients who had a