"SEE, IT DOESNT HURT ..."
SIR,-In England Now is one of your most agreeable fea-tures, but I cannot allow the contributor remembering"Wicked Willie" (Dec. 23/30) to say that it is good to encour-age children to believe false statements by adults merely tostop those children crying when hurt by an injection. Surelyit is wrong for parents and doctors-especially when they areboth-to dissemble to their children. Are not tears a human
expression of emotion, therapeutic in themselves and thereforeto be encouraged?92 Handsworth Wood Road,Birmingham B20 2PL ELSIE MAY
A CODE ON THE CHEST
SiR,-I would like to report an unusual case of pneumonia.A 13-year-old boy presented in May, 1978 with a 3-day history
of right-sided pleuritic chest pain and a 5-month history ofcough productive of clear sputum, with occasional haemoptysis.Whilst playing the game Mastermind at Christmas, he hadhidden a blue 1.4 cm peg in his mouth, to deceive his
opponent. Discovery resulted in deep inspiration-and disap-pearance of the peg. On admission to hospital he was febrile,with clinical signs of consolidation and collapse at the rightbase. A chest X-ray confirmed these findings but did notreveal a foreign body. However, at bronchoscopy, the master-mind peg (see figure) was removed from the right lower lobebronchus. The fever and the clinical and X-ray signs sooncleared with benzylpenicillin and physiotherapy, and he wasdischarged after 3 days.
I thank Dr G. de J. Lee for permission to report this case.
Department of Cardiology,Radcliffe Infirmary, Oxford N. S. ASHFORD*
*Present address: Department of Geriatric Medicine, Churchill Hospital,Oxford.
URINARY INFECTION AFTER MICTURATINGCYSTOGRAPHY
SiR,Dr Maskell and her colleagues report a urinary in-fection-rate of 30% after micturating cystourethrography(M.c.u.) and suggest that antibacterial prophylaxis should begiven for a few days before and after the investigation. Wedrew similar conclusions from a very similar study done fouryears ago2 with the aim of defining the rate of urinary infec-tion after M.c.u. and the effect of short-term chemoprophy-laxis. 142 children of both sexes aged two months to sixteenyears were studied. All had sterile urine and none was undertreatment at the time of the investigation. The bladder cathe-terisation was done by a physician working under aseptic con-ditions. Half the children (71) were given nitrofurantoin, a uri-nary antiseptic, for four days after the M.c.u. at a dose of 1mg/kg bodyweight every twelve hours. The other halfremained without treatment. Urine culture (dipslide) was done
,at home by the mother or in hospital by a nurse four to six
1. Maskell, R., Pead, L., Vinnicombe, J. Lancet, 1978, ii, 1191.2 Guignard, J. P., Fawer, C. L., Kroener, A., Quloz, J., Landry, M. Schweiz.
med. Wschr. 1975,105, 1654.
days after the M.c.u. All patients with 104 colonies or more /mlwere subsequently re-examined in the hospital. A finding of103 colonies/ml or less was considered to indicate artefactualcontamination of the urine.
Significant bacteriuria ( 105 organisms/ml) was found in5 out of 71 patients receiving no prophylaxis (7%) after cysto-graphy. None of the patients given nitrofurantoin had a uri-nary infection after the M.c.u. (r