ACUTE MALIGNANT GLANDERS IN MAN 



By W. E. MusGRAVE and A. G. SisoN 



{From the Clinics of the College of Medicine and Surgery, University of the 

 Philippines, and the Philippine General Hospital, Manila, P. I.) 



One plate 



There is a form of acute malignant rapidly fatal glanders in 

 man, the importance of which is not sufficiently emphasized in 

 the current literature of the subject. 



The four appended condensed case records form the basis for 

 the present discussion of this subject. 



INCIDENCE 



Human glanders, except in certain parts of Russia, is a rare 

 enough disease to make individual case reports of interest because 

 the diagnosis often, if not usually, is not made early in the disease. 

 For example, Meyer and Crohn ^ state that only 9 cases were 

 reported in the city of New York during two years. When one 

 considers the very contagious character of this infection, together 

 with the very close association between human beings and 

 horses, particularly in the Philippine Islands and most other 

 tropical countries, it is surprising that human glanders is not 

 more frequently encountered. The four cases from Manila would 

 suggest a greater incidence than is generally recognized in this 

 country. 



CASE I. ACUTE MALIGNANT GLANDERS — DURATION OF ILLNESS 

 FOURTEEN DAYS — DEATH 



Patient 599. — Filipino, male, 18 years of age, coachman by occupation. 

 Admitted to the hospital complaining of very high fever, severe pains in 

 the joints, and headache. Family history and history of previous diseases 

 unimportant. 



Present illness. — Eight days before admission, patient was taken sud- 

 denly ill with fever, headache, and nausea with occasional vomiting. 

 Within twenty-four hours, joint pains developed, starting in the right knee 

 and spreading rapidly to nearly all of the important joints of the body. 

 These pains were severe and acute in character, and a considerable amount 

 of oedema in and about the joints developed very rapidly. No external 

 wound nor primary lesions of the mucous membrane were discovered. 



^Journ. Am. Med. Assoc. (1908), 50, 1593. 



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