56
(i) A case of typhoid fever in which pyrexia lasted for 15 days. B.
typhosum was first isolated from the faeces on the 25th day of disease and the
organism persisted until the 73rd day. The maximum presence of Vi agglutinins
was demonstrated on the 32nd day which suggests that a relationship existed
between the late excretion of bacilli and the late rise in Vi agglutinins.
(ii) A proved case of typhoid fever in which B. typhosum was isolated
both in the primary attack and during a relapse from blood culture. During
convalescence paratyphosum C. was isolated from the faeces. It was not
possible to establish the fact that the original infection was a double one as it
was only after the B. paratyphosum C. had been recovered from the stool that
the blood serum was tested for the presence of these specific antibodies. It
was then found to contain both the flagellar and somatic antibodies of B.
typhosum and B. paratyphosum C., Vi agglutinins were also present.
(iii) A case of infection with B. paratyphosum A. primary pyrexia
lasted for 17 days, a relapse however occurred on the 23rd day and the tem-
perature then persisted for a further 30 days. During the relapse period the
following complications occurred. Severe intestinal haemorrhage, severe
haemorrhage from left nostril necessitating plugging, extensive ulceration
of the palate and right pillar of the fauces, inflammation of left parotid gland
accompanied by cellulitis of the whole of the left side of the neck, double otitis
media with perforation of both tympani, cystitis. B. paratyphosum A. was
isolated from a throat swab taken during the ulcerative period. The patient
recovered.
(iv) A case of infection with B. paratyphosum B. The patient was
admitted with all the symptoms of a very acute dysentery. No pathogenic
organism was isolated from the stool. Pyrexia persisted for 7 days during
which time a blood culture was taken which was negative. During a relapse
a second blood culture was taken from which B. paratyphosum B. was isolated.
Organisms sent to the Enteric Laboratory, Kasauli for confirmation or iden
tification.—Among the 246 cultures sent to the Enteric Laboratory during
the year the following were classified:—
Bacterium typhosum.
.
.
.
.
.
. 1 2 1
„
paratyphosum A .
.
.
.
.
.
.
.
43
, „
„ B
7
„
„
C .
.
.
.
.
.
.
.
3
„
enteritidis .
.
.
.
.
.
.
.
1
„
„
var Dublin
1
„
typhi-murium
.
.
.
.
.
.
.
.
2
„
alkaligenes (now motile)
2
The total number of cultures forwarded for identification or confirmation has
not materially changed from last year. The only organisms that were not
completely identified fell into the coli or para-colon groups and no attempt
was made to run these down to their species. The following remark was made
by the officer in charge of the Enteric Laboratory. " The preliminary identi-
fication tests of the majority of the organisms received appeared to have
been very satisfactorily carried out in Command, District and Brigade
Laboratories."
It is interesting to note the occurrence of B. paratyphosum B. infection
in numbers sufficiently high to be noticeable, though not in excess of last
year as far as military cases are concerned.
The strain of B. enteritidis shown in the above table was isolated from the
stool of a patient who was very dangerously ill. It was a very alarming case
of sudden and profuse diarrhoea followed by extreme collapse and typically