CHAPTER XXX. 



MICROCOCCUS MELITENSIS. 1 



Introduction. 



Section I. Experimental inoculation, p. 476. 



Man, p. 476. Animals, p 476. 

 Section II. Morphology, p. 476. 



1. Microscopical appearance and staining reactions, p. 476. 2. Cultural charac- 

 teristics, p. 476. 

 Section III. Biological properties, p. 477. 



1. Vitality, p. 477. 2. Biochemical reactions, p. 477. 3. Toxins, p. 477. 4. Im- 

 munity, p. 477. Vaccination, p. 477. 5. Agglutination, p. 478. 6. Immune body, 

 p. 478. 

 Section IV. Detection, isolation and identification of the organism, p 478. 



BRUCE gave the name Mediterranean fever to a disease which is very common 

 in Malta, and which had been mistaken for enteric fever or malaria until he 

 showed that it is a specific disease due to a specific micro-organism, the 

 Micrococcus melitensis. 



Mediterranean fever (Malta fever, undulant fever) occurs along the whole 

 of the Mediterranean littoral, in India, China, England, France, and other 

 countries. [Sir David Bruce has recently recorded an interesting and localized 

 epidemic in Central Africa to which the inhabitants had given the name 

 Muhinyo. ] 



In patients who have died of the disease the organism is found in pure culture 

 in the liver, spleen and kidneys. During life it can easily be obtained by puncturing 

 the spleen of infected persons, and it is generally present in the urine in the acute 

 stage of the disease and during convalescence (Durham). It only occurs in the 

 blood in small numbers and then mainly during the febrile attack. 



In the great majority of cases infection takes place through drinking 

 infected goats' milk (Bruce). In Malta, goats are frequently infected with 

 the micrococcus and eliminate the organism in their milk ; according to 

 Horrocks and Kennedy this is normally the case with 10 per cent, of the 

 Maltese goats. Direct contact with the sick is also a source of infection and 

 those who nurse them frequently become infected (Manson) : handling 

 infected milk and urine is particularly dangerous especially if there be an 



f 1 Though generally described as a coccus it has been decided to place this organism 

 among the gram-negative bacilli on account of the many affinities which it has with the 

 gram-negative bacilli of the typhoid-colon group and the absence of affinities with the 

 other gram-negative cocci. ] 



[For further information the reader is referred to the Reports of the Commission 

 for the investigation of Mediterranean fever (Harrison & Sons) and to Eyre's Milroy 

 Lectures, 1908.] 



