324 ACUTE GENERAL INFECTIOUS DISEASES 



Death results from asphyxia or severe enteritis. Intestinal 

 symptoms are commonly noted in this form. 



Pectoral Form. — ^The symptoms of this form are those of an 

 acute or subacute bronchopneumonia with pleuritis. The 

 patients stand with arched back, have a painful cough and, 

 .nasal discharge. Dulness is noted on percussion. Bronchial 

 sounds, rales, and rhonchi are heard on auscultation. The 

 patient is dyspneic, appetite is lost, and rumination sus- 

 pended. The constipation is later followed by diarrhea, 

 inanition, and death. 



Differential Diagnosis. — Hemorrhagic septicemia might be 

 confused with anthrax, Rinderpest and the subacute or 

 chronic pectoral form with contagious pleuropneumonia of 

 cattle. It might also resemble blackleg. The absence of 

 splenic enlargement, the normal appearance of the blood, and 

 the absence of the anthrax bacillus differentiate it from 

 anthrax. Rinderpest does not occur in the United States, 

 but is found in the Philippines. Outbreaks of Rinderpest can 

 usually be traced to an imported source (diseased cattle), 

 and in this disease, unlike hemorrhagic septicemia, a marked 

 ulcerous inflammation of the mucous membrane of the eye- 

 lids, respiratory and digestive tract is present. Contagious 

 pleuropneumonia no longer exists in this country. Macro- 

 scopically the lesions of the pectoral form of hemorrhagic 

 septicemia and this disease may be almost identical. In such 

 cases only the use of bacteriological methods can decide 

 (finding the bipoled bacterium; animal inoculations). In 

 typical cases of blackleg there should be no difficulty in 

 differentiation, as emphysematous surface swellings are not 

 seen in hemorrhagic septicemia. Furthermore the latter dis- 

 ease affects cattle of all ages while blackleg is essentially a 

 disease of young animals (see this) . 



Course. — ^The course varies with the form the disease 

 assumes, the severity of the infection and the resistance of 

 the individual patient. Acute cases last only a few hours 

 (6 to 20) while less acute ones may linger a week or even 

 longer. Those affected with the lung form usually live longer 

 than in the intestinal or exanthematous forms of the disease. 



Prognosis. — ^Very bad. Fully 90 per cent. die. 



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