Abstract
This study was done as a result of a report 1 stating that all patients with malaria had an abnormal liver function as tested by the cephalin-cholesterol flocculation test. Subsequently, in a report on phlebotomus fever, 2 Sabin et al. reported that in sand fly fever this test is negative and that the test can be used as an aid in differential diagnosis between that disease and malaria.
All our tests were done with a commercial preparation of cephalin-cholesterol and, at the start, readings were taken at 24 and 48 hours. In the middle of this series it was noted that some results apparently did not follow consistently if the 48-hour reading were used. The 24-hour reading appeared to give more consistent results. A series of tests were then performed on 20 psychotic patients. These produced negative results at 24 hours and positive reactions if the 48-hour readings were used. This has been previously reported. 3 Other factors tending to increase false positive reactions are light and temperature. More consistent results were obtained when tests were incubated in the dark at room temperature.
Our first series consisted of 114 patients and our second series of 102 patients. The tests were done within 24 to 48 hours after admission for a malarial attack and was repeated once a week, when possible, until the patient was discharged from the hospital.
Table I shows the result of the 2 series. It will be noted that if only one reading were taken, on admission, even with the reading of 48 hours, only 52% of the results were positive. If the 24-hour reading were used, more of the patients showed negative results. It is to be noted that Sabin et al. used the 24-hour reading in their report.
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