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April 27, 1935


JAMA. 1935;104(17):1490-1492. doi:10.1001/jama.1935.02760170028009

Papilledema is found as an occasional ocular complication in some diseases in which the symptomatology is so indefinite that a diagnosis can be made only after exhaustive clinical and laboratory studies. Undulant fever is such a disease and it has given rise to choked disk in some cases in which the central nervous system is involved. One such case was found in the domestic literature and four cases in that of foreign countries. Three cases, two of them with necroscopic data, are added in this report. Undulant fever should be considered in the differential diagnosis in cases of obscure etiology in which the optic disks are edematous.

Undulant fever, often called Malta fever, was first accurately described by Marston in 1861 as Mediterranean remittent or gastric remittent fever. The name "undulant fever," proposed by Hughes in 1896, is authorized in the accepted nomenclature of diagnoses. The etiologic agent (Brucella) was

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