176 BACTERIOLOGY FOR NURSES 



In man the disease appears as an intermittent fever, often 

 accompanied by pains of a rheumatic or neuralgic character. 

 The fever usually lasts from one to three weeks and may recur 

 from time to time during a period of several months. The or- 

 ganisms appear in the blood at the height of the fever and are 

 present in various organs and in the urine from the second day 

 to the end of the disease. Autopsies reveal degeneration both 

 of the liver and spleen. 



As an aid to diagnosis, blood cultures are usually made during 

 the period the fever is highest. A typical characteristic of Malta 

 fever is the appearance of agglutinins in the serum, which give a 

 marked reaction in high dilutions. The serum of a patient may 

 agglutinate the micrococcus melitensis in a dilution as high as 

 1 to 1000. Animals injected with the organism will produce a 

 serum which will react in dilutions as high as 1 to 100,000. By 

 this means suspected cultures can be readily identified. 



