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Ordinary acute pneumonia can scarcely confused with typhoid after the first day or two. Tuberculous Meningitis. This disease commonly suspected typhoid within the first few days, when no decisive professional dissertation help signs are present. The preliminary poor health, less degree fever, scaphoid abdomen, frequent vomiting, slower course in many instances, and the severity the headache, generally lead a correct diagnosis, before the advent Kemig's sign, rigidity the neck, ocular paralysis, or evidence from the examination the spinal fluid.

The generalized miliary form tuberculosis offers more trouble in exclusion, since the meningeal signs and symptoms may not present assist The increase the respiratory rate even or per minute, with cyanosis, and less physical evidence in the chest than one would expect, should excite suspicion. The diazo-reaction may present in either disease. The Widal test should tried and repeated if there a negative result, for write my essay website the positive reaction decisive. On the other hand, custom essay writing service reviews the positive result a tuberculin reaction no value, since many children with typhoid may still react, owing the presence tuberculous bronchial glands website that writes essays for you or other foci infection. Tubercles in the choroid occasionally offer decisive evidence. Spots upon the abdomen, indistinguishable from the eruption enteric fever, add the confusion in the early days. Departures from the rule as the type fever and the general character the pulse, suggest the tuberculous disease.

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As often the case in diagnosis, time necessary before certainty can obtained. In tuberculous peritonitis the abdominal distention, diarrhea, irregular fever, and rapid loss flesh lead the suspicion typhoid, but the greater mildness and chronicity the disease, the doughy feeling the abdominal wall, the presence effusion in the abdomen, practically never seen in typhoid, essay writer service review excepting after perforation, are sufficient for its exclusion.

Foci tuberculosis elsewhere, and especially the presence palpable glands, aid in certain cases. Cerebrospinal Meningitis.

From the clinical features impossible in many cases differentiate between this disease and the meningeal type typhoid, since the symptoms each are dependent upon congestion, irritation, and inflammation the meninges.

The two diseases may have in common sudden onset, vomiting, headache, photophobia, purpuric eruption, retraction the muscles do my writing homework the need help writing thesis neck, Kemig's sign essay help chat and delirium.

The examination the cerebrospinal fluid for the meningococcus, the presence a polynucleosis, the absence Widal reaction and the development herpes labialis, with great rapidity in the evolution i need to write an essay about myself the disease, point toward the cerebrospinal fever. Rose spots and abdominal symptoms lead rather Ulcerative Endocarditis. Perhaps a majority the cases this disease are at first taken for enteric fever. In ordinary cases there are sufficient physical signs found upon careful auscultation and percussion the heart prevent error. Presence leukocytosis, absence Widal reaction, possible presence minute reddish spots, indicating the lodgment small septic emboli, dissertation format and the absence any data essential typhoid aside from the fever and the enlarged spleen, should prevent error. I have seen the heart dilated a point beyond the nipple line with a loud mitral systolic murmur, high fever, abundant petechial eruptions and large spleen, and death before the blood was examined. My diagnosis was malignant endocarditis, but autopsy proved a case most typical fulminating hemorrhagic typhoid fever. Septicemia and Pyemia.

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