At postmortem we have an enlarged, congested, soft spleen with swollen Malpighian bodies. The kidneys may show a nephritis and the mesenteric glands be swollen. The intestines fail to show the characteristic lesions of typhoid fever.
There may be evidences of myocarditis.
Symptomatology
A Typical Case.—Following a period of incubation, varying from ten to fifteen days, headache, malaise and anorexia set in with a step-like rise of fever from day to day.
The tongue is not heavily coated and is red at the tip and sides.
Constipation is the rule and there is an early tenderness and enlargement of the spleen. There is much to suggest typhoid fever in the gradual ascent of the remittent fever for about ten or twelve days and the gradual descent during the succeeding ten or twelve days, but the lack of apathy and slighter evidences of toxaemia differentiate. The patient is dejected rather than apathetic.
There is often a slight bronchitis, with cough, which, when associated with a profuse sweating at night, may suggest phthisis.
Fig. 75.—Temperature chart of Malta fever. (After Scheube.)