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The Treatment of Undulant Fever with Sulfanilamide

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Abstract

Undulant fever is a serious disease of great clinical importance. It is probable that acute cases occur much more often than is recognized. Chronic undulant fever is a frequent cause of an unexplained elevation of temperature.

The symptomatology of the acute and chronic types is not characteristic. In acute cases the disease may be suspected from the unexplained fever, the sweating, joint pain, and negative physical examination. The causative organism is difficult to grow in blood cultures. The agglutination test is usually positive and often to a high dilution. In chronic undulant fever the organism is also difficult to isolate and agglutination tests are often negative. Here, intradermal tests and the determination of the degree of phagocytosis of the organisms by the patient’s leukocytes help greatly in making the diagnosis.

Even if the disease is suspected and the diagnosis is correctly made, the treatment has been very unsatisfactory. A specific vaccine may help in the acute form and specific and nonspecific vaccines, and induced hyperpyrexia seem of value in the treatment of some cases of the chronic type. Recently, sulfanilamide has been used in the treatment of acute undulant fever with very promising results. Stein and Blake1 have reported three cases so treated with prompt clinical cure. Blumgart2 has added another case successfully treated and has collected 13 cases treated by nine authors in Europe with apparent cure.

We have recently used sulfanilamide in the treatment of a patient suffering from acute undulant fever and rapid recovery has resulted.

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