Abstract
The recent studies of Zinsser 1 concerning the possible relationship of Brill's disease to a previous typhus fever infection suggests the importance of determining by a simple test a previous infection with typhus fever.
Inasmuch as many such patients are of foreign birth, and in whom infection had probably occurred some years previous, the clinical history is not always readily obtained. Likewise, a Weil-Felix reaction usually becomes negative with, or soon after convalescence and therefore cannot be used for this purpose.
The present work described the use of formalized Rickettsia suspension for this purpose. Fleck and Kurkowski 2 found that filtrates of Proteus X 19 were ineffective. Our tests were carried out with a formalized Rickettsia suspension made from tunica vaginalis scrapings kindly furnished us by Zinsser of Harvard University.
Accordingly, a series of 12 males who had had typhus fever, the diagnosis having been established 6 months previously in one case, and in the remainder from one year to 8 years were given the test about to be described. These cases were obtained through the courtesy of Dr. J. Rosenbluth, of the Bureau of Communicable Diseases of the New York City Department of Health. In all these cases the diagnosis had been confirmed by a positive Weil-Felix reaction with the exception of one in which the Weil-Felix had not been carried out.
For the control, 10 adults with no previous history of typhus fever infection were given a similar skin test. The test consisted of an intracutaneous injection of 0.1 to 0.2 cc. of formalized Rickettsia suspension. The patients were observed 24 to 48 hours after the injection. None of the controls gave any reaction, whereas all the 12 with the previous history of typhus infection showed an erythematous indurated area from 1 cm. to 4 cm. in diameter.
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