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To the Editor:
—The following case is instructive from the standpoint of surgical diagnosis:Miss X, aged 21 years, a nurse in Hahnemann Hospital, complained of anorexia and malaise for three days, at the end of which time she was suddenly taken with general abdominal pains. There was neither nausea nor vomiting. Her temperature was 102.4 F., pulse 120 and respirations 20. The white cell count was 12,000. The next morning, Dec. 27, 1914, the temperature was 103 F., the pulse 118, and pain and tenderness were localized in the right iliac fossa. Inquiry developed the fact that she had previously received immunizing injections of typhoid vaccine in another hospital as follows: Oct. 12, 1914, 500 million; Oct. 22, 1914, 1,000 million; Nov. 2, 1914, 1,000 million. The first dose was administered by the resident physician, the second by the supervising nurse and the third by a nurse in training.
Sappington SW. Possibility of Failure in Prophylactic Typhoid Vaccination. JAMA. 1915;LXIV(26):2157–2158. doi:10.1001/jama.1915.02570520051025
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