PEDIATRICS Vol. 2 No. 6 December 1948, pp. 752
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Re: Multiple Cystic Tuberculosis of the Bones, McLemore Birdsong, M.D., and Camillus S. L'Engle, Jr. Pediatrics 1:767, 1948

FRANCIS SCOTT SMYTH M.D.

The report by Birdsong and L'Engle in the June issue of Pediatrics, leaves me unconvinced. It is difficult to explain the finding of tubercule bacilli by the authors. One would like verification by guinea pig inoculation. This would seem a desirable check, since, peculiar for tuberculosis that was not as yet terminal or overwhelming (tuberculous meningitis), the tuberculin skin test was negative.

The reproductions of the X-ray films of skull and pelvis are strikingly similar to those of the Hand-Schüller-Christian, Letterer-Siwe disease. I do not believe the absence of foam cells in the biopsy rules out xanthomatosis.