^aS adm^ed to the Civil Hos- of. ' Karnal on 22. 10. '51 with .... THE INDIAN MEDICAL GAZETTE. [Dec. 1953 ... was given Chloromycetin by her doctor husband.
?^Ec-, 1953] murine By
T. N.
MURINE
typhus in
MATHUR,
Assistayit Bacteriologist,
TYPHUS
and was suffering from a remittent type ot lever of 11 days' duration with temperature ranging between 99 F. and 101 F. in the beginning and
karnal city.
100 F. and 103 F. later pains all over the body,
p.c.M.s. m.bas, d.t.m.,
Government of Punjab, Kan
She
very prostrated and anxious. There rash or eschar and there was no adenoThe spleen and the liver were not enThere were basal crepitations in both On the 3rd November 1951 i.e. on
in SimIa hills Cove11pathy. of murine typhus fromlarged. ^asaul' 1 and *so^ed strains of Rickettsialungs. ?>*oos r?m th6 l0Cal Pats' ^ove11 and Mehtathe twelfth day of her disease her blood 1^?^atec' s^rains of Rickettsia mooserishowed a Weil-Felix reaction of 1 in 1250 from tf ^le ^0Ca^ fats. Murine typhusagainst Proteus OX19. Her total leucocytic has al 0611 rePor^ed from a number of places count was 17,800, and the differential count ?n
typhus
She complained of sleeplessness and cough. on.
was
was no
StUdi6S (1936?1Sre^01^ec|
623
IN KARNAL CITY: MATHUR
cases
(1936)^
le,^eas
InrT?
*n
^
^ "^?as^m^r> Calcutta, Jubbulpur, showed polymorphs 88 per cent.; lymphocytes ^ysore and Bangalore by a number of8 per cent, and monocytes 4 per cent. Her Work ?owever no cases of endemic typhus physician had already given her one million ?f type 0X19 have so far been units of penicillin without any relief to her. *"ePorf GC 10m ^16 *^a*ns ^he state ?f Punjab. Her temperature came down to normal after 26 P0 endemic typhus of the serolo- hours when 2.5 gms. of Chloromycetin had been ^ rCases ?ical ^)e ^^19 were observed in Karnal city given in 0.5 gm. doses six-hourly. This patient in ??nths of October and November 1951.I was found infested with Pediculosis capitis; d e ai s of these cases are given below :?; but there was no other case of typhus in her family or in the colony where she lived.
&omh
a
'
th^
^e^?^?^cal
T
Case Reports
Case No. 3.?Miss Sheela, a school student, was the daughter of a physician in J-~~Mrs- B- Singh, a sixty years aged 16 years, New Karnal. the She had an acute Township ^aS adm^ed to the Civil HosPitil ' Karnal on 22. 10. '51 with the history onset of fever with chill on 30th October, 1951. of The fever was remittent. She complained of ?ntmuous Py^xia of 10 days' duration. The o over and headache. On the fourth ^radua^ and she complained of pains pain all all rash was noticed on her a day ^le body, body particularslight cough and constipatiQn over the abdomen, back, arms, forearms and n ^le ly ^ay Emission to the hospital hgj. + It was red and macular in character. It was 100 F. in the morning and legs. ^02 more was pronounced on the fifth day and be^10 but laps h' ln^? a even*n&- She was conscious visible with the rise of temperature better came i6 drowsy state during conversation, ail the towards evening. The temperature ranged ^as P10strated. There was no rash, no escl F. 100 and 104 F. She was prostrabetween n? aden?Pathy. The spleen and ted. Her Weil-Felix reaction on the fifth Were not day enlarged. On the eleventh day of 101 1^ness the Weil-Felix reaction was posi- of the illness showed agglutination of 1 in 125 Proteus OX19 and 1 in 83 against Pro* in 1250 f against Proteus OX19 against OXK. She was given Chloromycetin on Positive up to 1 in 83 against the 0 teus Silt' the sitxh day when the temperature was 104 F. typh?sus- She was given 0.5 gm. of ?1 After 36 hours she was afebrile when 1.75 gms. 010mycetin six hourly. She responded Pro mpt]y and her temperature came down to of Chloromycetin had been given in divided within the next 24 hours. The dose doses, 4-to 6-hourly.
^7/?r^aS
?V^'
plnPeia^urG ^ ^
livplar,and j1
^rnial
010myce^n sivV10urly for the
i?usy. t^S ^ eV6nth ^ay G
leu Coptic
cent^
then reduced to 0.25 gm. The Weil-felix reaction was repeated when next two days. The patient she had been afebrile for six days i.e. thirteen Her total leucocytic count on after the onset of the illness. The titre was
days ^,800 and differential of Proteus OX19 rose to 1 in 2500 whereas the polymorphs. 52 per cent. titre of OXK rose to 1 in 250 only. She had no cent. and monocytes 2 per eschar, no glandular enlargement or any history of insect bite. She was not lousy. She
was
count was
^GS ^ Per
No. .2.?Mrs. Bhatia, thirty-five o^ase ^ady, living dairy farm, Karnal, a
c
was
on
a
years
made
an
uneventful recovery.
There
was
no
624
THE INDIAN MEDICAL GAZETTE
other
case
of
in her school.
typhus
Her total
Her Widal
and Weil-Felix reactions are shown in Table I. Case No. 4-?Mrs. 13. Pal a forty years old
lady, on
mother of
the 11th
sudden and all
over
case no.
November, with a rigor.
3 started 1951.
getting
She had acute
was
count
follows
was as
was
pains
and headache.
remittent and
ranged
The temperature was between 100 F. and 103 F.
On the fourth day a red macular rash ticed on all her body and on the same
was no-
day
count
on
7,800 and
given Chloromycetin by her doctor husband temperature came down to normal within 30 hours of the administration of Chloromycetin. On the fifth day her blood was examined
the fifth day
differential
the
:?
Neutrophils
59%
Lymphocytes Monocytes Eosinophils
13%.
28% Nil.
after onset, Weil-Felix and Widal tests were peated. She was still positive for 0X19 up
Her
1 in 50 but the titre of
fallen from 1 in 125 to 1 in 25.
The result
The acute
set, body pains, rash and quick response
W. F. reaction
Showing
of
Case No. Ill Dilution
1/25
^
B. typhosus
B. -para A.
TT
H
H
B. para B.
..
..
Proteus OXK Proteus OX19
..
1/50
1/83
^ +
1/125
1/250
+
+
1/500
1/1,250
+ +
+
-f-
+
+
+
+
+
+
+
+
~"
+
+
+
Table No. 2 W. F. reaction
Showing
of
Case No. IV Dilution
1/25
Organism O
B. typhosus
B. para A-
O H
B. para B
O H
??
..
..
..
+
+
1/50
1/83
+
+
+
..
OX19
..
+
1/125 ~
+
-
+
+
-4-
4_
..
OXK
1/2,500
+
+
+
+
-
+
re-
had typhoid agglutinins
Table No. 1
Organism
1953
She continued to be afebrile after the fifth day. On the 28th November, 1951, i.e. 23 days
she
was
for Weil-Felix reaction and Widal. is shown in table II.
leucocytic
of the illness
fever
The onset
[Dec.
1/250 ~
-
on-
Dec., 1953]
MURINE
c hi
however left this case.
s m
^??d
day
?f
case
no.
I
as
doubt
no
c!iarfnr,rr'"'CC'^n
IN
TYPHUS
in 250 against P?sitive up to 1 not no. 2 did 9' while that of case thirty1 in 25, aggiutillins even in first The the fever-
w
s*x
^
dav^
the ?nset of have ^ia
