1. Reasons are given why acute osteomyelitis and suppurative arthritis of infants should be considered as a separate entity. 2. The differences between the 2 types are reviewed. 3. The etiology and bacteriology are discussed. 4. The clinical picture, complications, differential diagnosis, prognosis and treatment are considered in detail. 5. Five illustrative cases are fully represented.
Twelve cases of the Katayama syndrome or toxaemic stage of bilharzia are descriptionbed. The clinical picture of fever, headache, cough, abdominal pain, urticaria, enlarged liver, enlarged spleen and a high blood eosinophilia is descriptionbed in detail. The syndrome in this country is caused by S. haematobium or S. mansoni. Mixed infections also occur. Of 10 cases in which ova were found 7 had S. mansoni in the stools and it is suggested that this infection is becoming more prevalent in this area. The eosinophilia is usually very high and may reach 80%. The bilharzial complement-fixation test may be a useful diagnostic test. In areas where bilharzia is endemic the Katayama syndrome should be considered when an unexplained fever presents. The impression has been gained that treatment with large doses of 'nilodin' (100 mg. per Ib body weight over 8 days) is at least as satisfactory as intramuscular antimony in cases due to S. haematobium. In those due to S. mansoni it is thought best to follow 'nilodin' with antimony and to repeat the course later.
*Paper read at the first conference of the South African Paediatric Association held at Durban 21 August 1953. The prolonged recalcification time and the prothrombin consumption test put this case into the haemophilic and 'haemophilic-like' group of haemorrhagic diatheses. The defect in the case has been corrected by the addition of haemophilic plasma and by a normal control. In addition, the addition of plasma from a case of 'Christmas Factor' has failed to correct the defect. This would imply that this is not a case ofhaemophilia, but that the defect in this case is Factor VII or the associated so-called Christmas Factor.