KHARTO U MEN SIS PA RENTERIC 



1413 



oides of intestinal bacteria, and is closely related to B. entericus 

 Castellani, 1911, and 5. parentericus Castellani, 1914. 



Symptomatology. — After a preliminary period of one to three 

 days, during which the patient suffers from headache, constipation, 

 and malaise, with marked or slight fever, the febrile attack sets in 

 with constipation, headache, and a disinchnation for mental or 

 bodily work. The heart, lungs, liver, and spleen remained normal, 

 and, except for the usual febrile changes, the urine was also normal. 

 Except for headache, the nervous system was normal, and no skin 

 eruptions were noticed. The cardinal features of the illness were 

 constipation, fever, relatively slow pulse, headache, malaise, and a 

 general feeling of illness. 



After about seven days from the commencement of the true rise 

 of temperature the fever, which had gradually risen to a maximum 



Fig. 667. — Temperature Chart of Khartoumensis Parenteric. 



lying between 101° and 103° F., subsided quickly, and in about an- 

 other three days fell to normal, when the disease ended, or to nearly 

 normal, and was followed by a relapse of a more irregular and pro- 

 longed nature. When the temperature subsided all symptoms 

 gradually disappeared and the patient felt quite well, but if the 

 relapse occurred the headache, lassitude, constipation, etc., re- 

 turned. At no time was any patient seriously ill, and at no time 

 did a purgative produce other than good effects. 



The condition somewhat resembles a case of enteric, but the 

 spleen is not enlarged and roseola is not present. 



The diagnoses is made on finding B. khartoumensis in the faeces 

 and by the serological reactions, while all the tests for enteric are 

 negative. 



The prognosis is favourable. 



The treatment is symptomatic, but vaccines might be tried. 



REFERENCES. 

 Enteric. 



The literature on Enteric Fever is very large, and for the more important 

 references the reader is advised to consult the ' Index Medicus.' 



Bainbridge and O'Brien (1912). Journal of Hygiene. Cambridge. 

 Birt (1907). Journal Royal Army Medical Corps. London. (Typhoid and 

 Paratyphoid Fevers.) 



