On tertiary syphilitic fever and the visceral and other changes connected with it / by F. Parkes Weber.

  • Frederick Parkes Weber
Date:
[1907]
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Licence: In copyright

Credit: On tertiary syphilitic fever and the visceral and other changes connected with it / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    supposed to have malaria and then pulmonary tuberculosis,, but the appearance of a gumma on the leg led to the re- cognition of the syphilitic origin of her illness and to its speedy cure by antisyphilitic treatment.8 Fever is, however, no more a necessary accompaniment of pulmonary syphilis than it is of hepatic syphilis. Sidney Phillips 9 in 1889 pointed out that syphilitic fever might easily be mistaken for malaria. His case had definite ague-like chills and resembled tertian fever. There were, apart from what seemed to be erythema nodosum, no definite local lesions, but the symptoms yielded promptly to antisyphilitic treatment. One of Futcher’s three cases10 of syphilitic fever was characterised by intermittent chills with fever and was treated first as a case of malaria, but after- wards yielded readily to antisyphilitic treatment. Veress 11 quotes a case of Eckert, of Tientsin, in which tertiary syphilitic fever was accompanied by shivering attacks and enlargement of the spleen so as to simulate a form of malaria. Confusion with malaria is, of course, most likely to occur in malarious countries and when the spleen is enlarged and when there are definite attacks of shivering. Needless to say, typhoid fever, malignant endocarditis, and febrile cholelithiasis may all be thought of in cases of tertiary syphilitic fever. One of the cases recorded by Futcher12 was for weeks suspected of being a case of typhoid fever and was treated as such, but the correct diagnosis was established by the discovery of periosteal thickening over the clavicles and by the cessation of the fever after the beginning of treatment with potassium iodide. The presence of “tertiary syphilitic diarrhoea ” 13 in such cases would still further increase the clinical resem- blance to typhoid fever. Definite clinical signs of valvular disease may, as is well known, be absent for a long time in' cases of malignant endocarditis, and syphilitic fever of intermittent or remittent type might be mistaken for early malignant endocarditis before the development of a definite murmur ; such a mistake would be more likely to occur if there happened to be an old valvular lesion present, of rheu- * On Fever in Cases of Pulmonary Syphilis see also A. Stengel, Syphilis of the Lungs simulating Pulmonary Tuberculosis, Univer- sity of Pennsylvania Medical Bulletin, May, 1903, p. 89. 9 Loc. cit. 10 T. B. Futcher, loc. cit. 11 Loc. cit. 12 Loc. cit. !3 See later references to the rare cases in which tertiary syphilis is accompanied by obstinate diarrhoea.
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