ATYPICAL SUBTERTIAN FEVERS 



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Delirious Type. — In this form delirium is the most marked 

 feature, and in a short time is followed by exhaustion, coma, and 

 death. Such cases are apt to come on suddenly, and to be mistaken 

 for drunkenness, sunstroke, or mania. The fever is usually very 

 high. Recovery is supposed to occur, but we have never seen these 

 cases end otherwise than fatally. 



Tetanic Type. — Patients delirious from malaria may show 

 trismus, contraction of the limbs, opisthotonos, retraction of the 

 abdomen, and conjugate deviation of the eyes. The contractions 

 of the muscles may relax and increase as in tetanus, and there 

 may be priapism. The attack may resolve, or end in death with 

 high temperature. 



Convulsive Type. — Children during an attack of fever may develop 

 convulsions, followed by stupor, or even coma and death. 



II. SUBTERTIAN SYNDROMES WITH LOCALIZATION 



The subtertian syndromes with localization may be classified 

 into: — 



L Syndromes with ' nervous system ' localization. 

 II. Syndromes with ' digestive system ' localization. 



III. Syndromes with ' respiratory system ' localization. 



IV. Syndromes with ' circulatory system ' localization. 

 V. Syndromes with ' ductless glands ' localization. 



VI. Syndromes with ' urogenital ' localization. 

 VII. Syndromes with ' cutaneous ' localization. 

 VIII. Syndromes with ' special sense ' localization. 



I. With 'Nervous System' Localization. 



The atypical subtertian malarias with nervous system symptoms 

 may be classified as follows: — 



1. Meningitic type. 



2. Hemiplegic type. 



3. Monoplegic type. 



4. Myelitic type. 



5. Ataxic type. 



6. Disseminated sclerotic type. 



7. Bulbar type. 



8. Cerebellar type. 



9. Cerebral type. 



10. Polyneuritic type. 



11. Korsakoff type. 



12. Aphasic type. 



Meningitic Type. — Fever with signs of meningitis may be found 

 in young persons and children. The symptoms are vomiting, 

 headache, retraction of the head, and rigidity of the neck, convul- 

 sions, hyperaesthesia, going on to coma and death. There may be 

 hypertension and slight lymphocytosis of the cerebro-spinal fluid. 



