The Blood Picture of Izurni-Fever Patients at Minamiota Primary School of Yokohama City in 1954

Abstract

This report is a summary of the blood picture studied daily on 267 Izumi-f ever patients at Minamiota Primary School, Yokohama City, in March 1954.
The leukocyte count, after an initial increase in many cases, showed a fluctuation parallel to body temperature. The initial temperature fell on the 4th to 7th day of disease, with a corresponding fall in the leukocyte count to a value of 8. 600 on an average. At the stage of secondary fever the number of leukocytes increased again and returned to a normal level only after the lapse of disease.
There were, however, some cases, which did not show leukocytosis throughout the course of disease. They might give normal leukocyte count or they had leukopenia.
The main component, which caused the initial increase in leukocyte count was the neutrophilic polynuclear leukocyte. This showed not only an increase in number, but also a shift of nuclei to the left, and had DOhle's bodies in 22. 0% of the cases. Toxic granules. were demonstrated more clearly at the early stage of disease.
Leukopenia, if present, was likewise caused by a decrease in neutrophilic polynuclear leukocytes.
The average number of eosinophilic leukocytes was normal or rather decreased in many cases before the 3rd day of disease, and was followed by a sudden increase after the 4th day.
Leukopenia with decrease or disappearance of eosinophilic leukocytes, as reported by Kasahara and others, was not confirmed with our cases The grade of eosinophilia was independent of the presence or absence of parasite eggs in stool, and no particular variation in eosinophilic leukocytes was observed even in patients with concurrent erythema nodosum.
Lymphocytes increased only after the 4th day of disease, to reach a maximum value after the 3rd week.
Many patients had slight or moderate monocytosis. Plasma cells and atypical cells were found in the majority of the cases after the 4th day of disease. Both of them, however, rarely exceeded 4% of the total leukocyte count.
The erythrocyte count was normal or slightly reduced. Slight reduction in hemoglobin content was recognized in some cases, without any morphological abnormality of erythrocytes.
The fever types were classified into 5 groups according to Kodama and Iimura. No particular relation was f ound between the leukocyte pictures and the fever types. Nor a definite difference was confirmed in hemogram between Izumi-fever and scarlet fever, contrary to the reports of Abe and others. Two, patients out of this epidemic were later readmitted, to our hospital, on account of newly infected scarlet fever. Comparative studies of blood pictures of the patients in both diseases, failed to reveal any significant difference.