Rarely a rise of 3 or 4 degrees which does not last more than forty-eight hours may be present in a stage of reaction going on to a favorable convalescence.
It must be remembered that the rectal temperature in the majority of cases of cholera may show elevation of temperature approximating 100°F., while the axillary temperature may be as low as 95°F. When there is a great difference between the rectal and axillary temperatures, instead of the more common 4 or 5 degrees of a typical case of cholera, the prognosis is bad. The temperature taken by mouth may be as low as 86°F.
Leprosy.—Among the prodromata of leprosy, along with epistaxis, feeling of great weakness, somnolence and occasional sweats, there may be recurring attacks of fever. These are at times diagnosed as malarial manifestations. With the appearance of typical lesions the course is apt to be nonfebrile with the exception that febrile accessions often accompany the early macular manifestations.
Amoebic Dysentery.—Unless complicated by hepatitis or some bacterial infection of the amoebic lesions the disease progresses without fever.
Sprue.—While sprue is certainly one of the most typical of afebrile diseases yet a form of sprue is recognized which begins as an acute entero-colitis with fever. This must be most exceptional, or only a coincidence, as sprue is characterized by a very insidious onset.
Ancylostomiasis.—The occasional reports of fever being present are probably connected with bacterial infection at the site of attachment of the hookworm.
Filariasis.—There is a febrile manifestation of filarial disease which is attended by rigors and high fever. This is a lymphangitis which causes an erysipelatous appearance about the region involved. It is these recurring attacks of lymphangitis which gradually lead to the enormous thickening of the skin characteristic of elephantiasis. Such attacks are designated elephantoid fever. They are often diagnosed as malarial chills and in Barbadoes, where there is no malaria, such attacks are called “ague.”
Lymph scrotum is the filarial condition in which elephantoid fever is most frequently noted.
Schistosomiasis.—In the vesical type of the disease we may have as a complication a pyelitis which could give rise to febrile manifestations. In Japanese schistosomiasis the disease sets in with fever and urticaria. Before this combination of symptoms was recognized as belonging to schistosomiasis we designated it urticarial fever.