A Case of Enteric in Which the Widal Reaction Became Positive on the 49th Day

Condition on admission.?Temperature, 102?F.; pulse rate, 112; respirations, 26 per minute. The pulse was of fairly good volume and did not give any indication of internal haemorrhage at the time. Tongue, coated and moist. Abdomen, slightly tympanitic, resonant all over, and not rigid. No enlargement of spleen and liver. Bowels constipated for about four days after the last two hemorrhagic stools. The case was clinically diagnose,d as a case of enteric and the treatment was carried for this disease. Just after his admission he was given a simple enema and as a result of which black ( ? altered blood) fluid was returned. The stool contained occult blood. The Widal test was positive (1 in 25) to B. typhosus 011 the 2nd day after admission, negative on the 7th and 13th day, and again positive (1 in 500) to B. typhosus on the 24th day after admission (49th day of the disease). The blood culture was sterile on the 7th, 13th and 24th days and the urine culture 011 the 9th, 19th, and 23rd. No enteric group organisms were found in the stool, examined on the 9th day after admission. The first Widal test, which was positive to B. typhosus, l\25 only, was of no importance. The Widal being negative on the 38th day, we grew anxious as to the real causative factor of the temperature which now became more or less of an intermittent type. Still a negative Widal could only be explained by low body resistance, but we had to keep our minds open to other