HMMOCYSTOZOON FEVER 



1469 



The fever came on after the removal of a tumefaction in the neck. 

 Spleen and liver were enlarged, and there was great anaemia and 

 emaciation. Brumpt considers that the organism is a herpetomonas, 

 and compares the non-fiagellate forms to Schizotrypanum cruzi, 

 while the flagellate, he thinks, are contaminations, but Franchini 

 does not agree. 



He reports that he has found in smears from the liver — 

 (i) Oval and lanceolate forms 3-6 and i-2»5 microns, without 

 blepharoplast or flagella. (2) Oval or lanceolate forms, sometimes 

 dividing, 16x3 microns. (3) Flagellate forms, with a flagellum 

 arising near the blepharoplast. (4) Non-flagellate forms with a 

 large nucleus. (5) Encysted forms with chromatinic masses. 



The patient had enjoyed good health until three years previously, 

 when he began to feel ill and lost his appetite, while his weight 

 declined. One year later a hard indolent tumefaction appeared 

 on the right side of the neck. This was removed, but the wound 

 did not heal and discharged a white non-purulent secretion. He 

 now began to suffer from irregular quotidian fever, preceded by 

 shivering and followed by sweating. The spleen became somewhat 

 enlarged, but the liver gradually extended to the umbilicus, and a 

 cyst formed in the right lobe, puncture of which gave a reddish 

 fluid. The patient now became very anaemic and emaciated. The 

 lymphatic glands were normal, the urine showed traces of albumen, 

 the blood showed signs of acute anaemia, with leucopenia, no eosino- 

 philia, and a few parasites. Puncture of the liver showed more 

 parasites. 



No malarial parasites, leishman bodies, spores, or fungi could 

 be found by examination or by cultures. Wassermann's reaction 

 was negative. Sections of the tumefaction showed granulomatous 

 tissue and some parasites. 



SEPTIC BILIOUS FEVERS. 



A febrile complaint described by Gartan, in 1918, as occurring 

 mostly in women, associated with enlargement and tenderness 

 of the liver, and lasting five to thirty days. One death is recorded. 



BUNGPAGGA. 



This appears to us to be myositis purulenta tropica (vide p. 1975) 



ROBB'S HEAT FEVER. 



This is described as non-infective cerebro-spinal fever, occurring 

 in East Africa. 



