Foreign Title :
Appunti Clinici sopra le Epidemie de Febbre dei Tre Giorni verificatesi a Forli nel Triennio 1909-1911.
Malaria e Malattie dei Paesi Caldi
Outbreaks of sandfly fever occurred among the troops at Forli (near Ravenna) in July and August of each year. The cases were much more numerous in some barracks than in others. The fever was not contagious. Its incubation period was under 8 days. The onset was sudden. The temperature rose rapidly to 40°or 40.5° C. There was severe frontal headache; pains in the back and lower limbs, especially in the knees; the conjunctivae were congested, and photophobia was often present. The tongue was furred, and sometimes vomiting and diarrhoea occurred. Mental depression was frequent and occasionally the patient became delirious. The pyrexia declined gradually. In 80 per cent, of the attacks the pulse-rate was slow, often only 90 at the height of the fever, but might fall as low as 40. The leukocytes numbered 4, 500-5, 000 on the second day, falling to 3, 000-3, 500 on the third day. The mouonuclears were relatively increased. The leucopenia continued till the eighth or tenth day. Bacteriological examination of the blood was negative. The duration of the pyrexia was usually 60 hours, but varied from 36 to 72 hours. Convalescence was slow, weakness continuing for ten or fifteen days. Acute nephritis was a complication in two instances.
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