1360 



RAT-BITE AND CAT-BITE FEVERS 



purple-coloured eruption and a non-suppurative adenitis following 

 a rat -bite should make the diagnosis easy. The discovery of the 

 spirochaete in the blood confirms the diagnosis. 



Prognosis. — This is good, as the mortality is only about 10 per 

 cent., and death is most usually due to collapse or septicsemic 

 symptoms during the first attack, or to nephritis or to complications. 



Treatment. — Treatment by salvarsan is quite successful. For 

 details of the treatment see pp. 1313 and 1560. Mercury has been 

 recommended by Borelli. 



Prophylaxis. — ^The rat -bite should be thoroughly disinfected. 



CAT-BITE DISEASE. 

 Definition. — relapsing fever caused by a spirochsete, probably 

 identical with Spiroschaudinnia morsusmuris, introduced by a cat's 

 bite or scratch. 



History. — Cat -bite disease was first described in Japan by Fujida 

 and Sato in 1902, while Izumi and Kato, in 1917, brought forward 

 evidence to show that the causal organism was a spirochcete, probably 

 identical with S. morsusmuris. In 1917 Sano described a case due 

 to scratches caused by a cat. 



etiology. — Futaki and Ishihara, Ido, Ito, Wani and Okuda, 

 Izumi and Kato, have all found spirochsetes in the blood of patients. 

 They were discovered by the first named and confirmed by the 

 others. The last named believe this spirochaete to be the same 

 as that causing rat -bite, because — 



I. The serum of a patient suffering from cat-bite, when mixed 

 with an equal quantity of guinea-pig blood containing rat -bite 

 spirochsetes, immobihzes them. When repeated with normal and 

 syphilitic serum the spirochsetes are not affected. 



II. When I cubic centimetre of guinea-pig blood containing rat- 

 bite spirochsetes is mixed with 2 cubic centimetres of the blood of 

 a patient suffering from cat -bite, and then the mixture injected into 

 the peritoneal cavity of a guinea-pig and removed in an hour, no 

 spirochsetes are found. In a control guinea-pig the spirochsetes were 

 abundant and active. 



III. In II. the first guinea-pig remained healthy and the control 

 died. 



Symptomatology — Incubation. — ^This varies from teh to twenty- 

 one days. 



Attack. — ^The onset begins with some premonitory symptoms, 

 followed by fever, pains in the muscles and joints, enlargement of 

 the spleen and the lymphatic glands. Infiltration of the skin takes 

 place near the site of the bite, and macular or urticarial eruptions 

 which spread all o r the body. 



The bite may heal readily or may ulcerate deeply. 



Course. — ^The fever is of the relapsing type, the intervals being 

 some three to nine days, and without treatment the disease will 

 last for months. 



Diagnosis. — ^This is the same as for rat -bite fever. 



