VARIETIES OF PARENTERIC 



1409 



The post-mortem reveals lobular pneumonia in the lungs, fatty degeneration 

 of the heart-muscle and liver, enlargement and softening of the spleen, and 

 congestion of the kidneys, with swelling of the tubular epithelium. 



Symptomatology. — The incubation period varies from seven to twelve days, 

 after which the disease may begin suddenly with a chill, but more usually 

 commences insidiously, like typhoid fever, with headache, malaise, etc., and 

 a rise of temperature from 102° to 104° F., with a pulse-rate of 100 to 120 per 

 minute, quickened respirations, cough, and muco-purulent expectoration. 

 Rales may be heard over the lungs, while the spleen is enlarged, the tongue 

 dry and furred, and diarrhoea or constipation may be present. Rose-coloured 

 spots appear on the skin, and the patient becomes dull and stupid, in which 

 condition he may remain for several days, and as a rule will recover in about 

 fifteen to twenty days if no pneumonic complication intervenes. If, how- 

 ever, pneumonia sets in, the patient becomes much worse, and as a rule dies. 



Diagnosis. — The diagnosis is to be made by the discovery of sick parrots in 

 houses in which people are suffering from typhoid-like fevers and pneumonia, 

 Bacteriologically, attempts may be made to obtain cultures of the bacilli 

 from the blood. 



Prognosis. — The prognosis is grave in old people and when pneumonia sets 

 in, the mortality being stated to be about 35 to 40 per cent. 



Treatment. — The treatment must be conducted on the lines usually laid 

 down for typhoid fever and pneumonia. 



Prophylaxis. — The infected parrots appear always to come from South 

 America; therefore care should be taken that only healthy birds are allowed 

 to be shipped, and that these are kept in good hygienic conditions during the 

 voyage. On arrival at their destination, they should be quarantined for 

 about a couple of weeks, and, if found to be infected, should be destroyed, 

 and their dead bodies and cages burnt. The places in which they were kept 

 should also be thoroughly disinfected. Parrots should not be allowed to take 

 food out of people's mouths, and should always be kept in good hygienic 

 conditions. 



Alkaligenes Parentertc. 



Remarks. — B.Jcecalis alkaligenes Petruschky — which belongs to the 

 genus Alkaligenes of our classification — is generally a harmless faecal 

 germ, but researches by various observers have demonstrated that it 

 may occasionally become pathogenic for man, and produce fever. 

 Cases have been recorded by Straub and Krais (1914), by Rochaix 

 andMarode (1916), by Shearman (1916), by Hirst (1917), and others. 



Symptomatology.— The fever often resembles a mild type of 

 enteric, and is generally of short duration, twelve to fifteen days, 

 though protracted cases are occasionally met with. At times the 

 temperature is very irregular, subcontinuous or intermittent, and 

 even a tertian periodicity is said to be occasionally present, though 

 possibly some of these cases may have been associated with malaria. 

 The spleen is seldom enlarged, roseola is not present, and intestinal 

 haemorrhages have never been recorded. 



Diagnosis. — This is based on the isolation of B. fcacalis alkaligenes 

 from the blood, a.nd the presence of specific agglutinins for this germ, 

 while all bacteriological tests for enteric and other intestinal gernis 

 are negative. The bacteriological examination of the blood is 

 carried out as in enteric, either using Castellani's dilution method, 

 details of which have been given when discussing the bacteriological 

 diagnosis of enteric, or one of the modifications of Drigalski-Ccnradi's 

 bile method. The technique which, in the hands of Shearman, has 



