Annual report / Department of Public Health, Research Institute and Endemic Diseases Hospital.

  • Egypt. Maṣlaḥat al-Ṣiḥḥah al-ʻUmūmīyah. Research Institute and Endemic Diseases Hospital.
Date:
[1936]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report / Department of Public Health, Research Institute and Endemic Diseases Hospital. Source: Wellcome Collection.

    67/88 (page 57)
    178 cases of malaria, the association of enlarged livers and spleens is shown in the following table :— Table 39 • M.T. B.T. Total Hepatomegaly only. 2 2 4 Splenomegaly only. 23 11 34 Hepatosplenomegaly . 100 40 140 This table shows that malignant malaria is 24 times more common in the causation of hepatosplenomegaly than benign tertian malaria. These data agree with those given in the previous report about malarial hepatitis. (See previous report.) This type of hepatosplenomegaly resembles closely, in many cases the liepatosplenomegalic stage of Billi. H.L. Fibrosis so much that, in certain cases, it was impossible to decide which of the two conditions is responsible for the clinical picture without more detailed investiga¬ tions. This similarity has already been demonstrated by examining such cases in Fayum. (See previous report.) As a result of this difficulty encountered in separating these two conditions, investigations were undertaken during this year to arrive at the proper diagnosis and differentiation of this group. This is not only important from the point of view of proper diagnosis and correct treatment, but also to save such cases from undergoing splenectomy which will expose them, in addition to the surgical risks, to lowering of their defensive mechanism against malaria and other infections as well. The following observations and laboratory procedures were found of value in this connection (1) Clinically.— There’ is nothing much to gain except when (a) A typical history of regularly periodical rigors is given ; history of rigors of an irregular character is common in cases of Billiarziasis due to the presence of pyelitis. . . » • * * ** \ (b) Tenderness of the liver and spleen are present; the liver in pure cases of Billiarziasis is not tender. (See report of 1934.) (c) The enlarged liver is not cirrhotic ; in addition to absence of clinical signs of cirrhosis, a negative T.A. is of value in this respect. —. -