On Three Cases of Idiosyncratic Urticaria in Course of Relapsing Malaria

Sen Gupta (1942), summing up the current opinion of different workers on the subject, thinks that the symptoms of idiosyncrasy in the course of a malaria infestation are due to hypersensitiveness to the malaria parasites or products of the destruction of the red blood cells ; that would explain why the symptoms v of idiosyncrasy usually appeared at the onset of the malarial paroxysms and never, so far, in clinically fresh cases. Case 1.?P. L., male, aged 30, admitted under raj' care oil 17th June, 1942. Malaria (vivax) in 1940 (Lower Sudan). Typical attack of malaria fever with acute pain in the right iliac fossa in the afternoon of the 16th. The rise of temperature was accompanied by a generalized itching, and the patient was covered with a papular rash for about 2 hours. Another attack of fever at noon on the 18th, and again for two hours, during the hot stage, the patient was covered with a diffuse urticarial rash with red, hot, vaso-paralytic intervening skin. Put on antimalaria treatment (a blood slide had shown young and adult schizonts and gametocytes of Plasmodium vivax). He had another mild attack of fever accompanied by an urticarial rash for 3 hours on 20th June. His examination showed a spleen just palpable and slightly tender, and marked tenderness in the McBurney area during the malarial paroxysm. Blood tests normal. Having completed his antimalaria course, the patient was discharged on the 12th of June. Up to April 1945 he suffered no further relapses. Case 2.?G. R., male, aged 28, admitted under my care on 13th July, 1943. Malaria (vivax) in 1942, relapsed in March 1943. On the 12th, a typical attack of malaria accompanied by severe generalized itching and, during the hot stage, by a papular rash which disappeared in few hours. A new paroxysm on 14th July, accompanied by an urticarial rash, lasted two hours during the hot stage. A blood slide showed trophozoites and gametocytes of Plasmodium vivax. The patient underwent a course of antimalaria treatment and made an uneventful recovery. Case 3.?G. C., male, aged 49. Admitted under my care on 18th September, 1943. Malaria (vivax) in 1940, relapsed in June 1941 and September 1942. On the 16th he had a typical attack of malaria accompanied by a very pruriginous, papular rash, lasting about 2 hours during the hot stage. He was admitted in the afternoon of the 18th during the hot stage of another paroxysm of malaria, covered with large elements of urticaria which lasted about 3 hours. He