Image from page 1121 of "Medical diagnosis for the student and practitioner" (1922)
Authors: Greene, Charles Lyman, 1862-
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress
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Fig. 518.—Epi-demic Spinal Menin-gitis. Meningococcusin centrifugated cere-bro-spinal fluid.Stained with Loef-flers Methylene Blue. Hydro-cephalus Irritativesymptoms. io8o MEDICAL DIAGNOSIS Facial spasm, strabismus and ptosis are common, pain in the head, backand extremities is decided and progressive and, less frequently, the trunk musclesmay be paralyzed. Hyperesthesia of spinal or general localization is often noted andmarked irritability may give place to delirium, stupor and finally coma.Albumin, sugar, and in malignant cases, blood, may be present in the urine. The fever curve is extremely variable, some cases showing hyperpyrexia,others almost no fever.
Text Appearing After Image:
Fig. (After Knopfelmacher.) Respiration is not markedly increased. The pulse is sometimes remark-ably slowed and almost always weak, but in children may be much accelerated. Leucocytosis is present in all cases (20,000 to 40,000).* The bowels areusually constipated, the spleen moderately enlarged, excessive vomiting, with-out nausea and of the projectile type, is an unusual but troublesome com-plication. Skin Rashes.—The cutaneous symptoms vary greatly, herpes is almostconstant and purpuric spots occur in from two-thirds to three-fourths of the cases. * Leucocytosis is sometimes present in tuberculous cases though not so constantly. MENINGEAL INFECTIONS I08l Dusky mottling, erythema, rose spots, urticaria and various eruptions may bepresent. Malignant cases may kill so promptly that the brain shows at autopsyonly an acute congestion. They are sometimes apyretic and are almostinvariably associated with purpuric rash and feeble pulse, somnolence andprofound asthenia. Intermittent Form
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