. The diseases of infancy and childhood. ocolitis is usually from one to threeweeks. Death takes place from sepsis, exhaustion, or from complica-tions. It is probable that almost every case of the severity describedterminates fatally when it occurs in an infant. In older children theprognosis is much better as to life, but in them the acute attack maybe followed by the chronic form of the disease. Diagnosis.—Ileocolitis .is to be distinguished chiefly from typhoidfever, intussusception, and meningitis. Typhoid is distinguished by theslower invasion, more constant temperature, enlargement of th
. The diseases of infancy and childhood. ocolitis is usually from one to threeweeks. Death takes place from sepsis, exhaustion, or from complica-tions. It is probable that almost every case of the severity describedterminates fatally when it occurs in an infant. In older children theprognosis is much better as to life, but in them the acute attack maybe followed by the chronic form of the disease. Diagnosis.—Ileocolitis .is to be distinguished chiefly from typhoidfever, intussusception, and meningitis. Typhoid is distinguished by theslower invasion, more constant temperature, enlargement of the spleen,tympanites, and most of all by the Widal reaction and the colitis should not be confounded with intussusception; yet therecords of intussusception show that a very large proportion of the caseswere regarded in the beginning as cases of dysentery. In intussuscep-tion, although there is a sudden onset with acute pain, tenesmus, vomit-ing, and marked prostration, there is rarely fever. The later symptoms PLATE VII. Membranous Inflammation of the IleumA delicate child, eleven months old; mild diarrhea for two weeks without fever; acute severe symptoms for twelve days; temperature, 100° to ° F.; green and mucous stools; no blood. The lesions involved the last foot of ileum and entire colon. Specimen is from lower ileum, and shows the abrupt termination of the lesion; the upper part shows normal small intestine; A is a Peyers patch; B is the inflamed part of the intestine; it has a rough granular appearance and is much thickened. ACUTE ILEOCOLITIS 387 —absolute constipation, tumor, stercoraceous vomiting, and collapse—have nothing in common with colitis. The membranous form may beconfounded with meningitis, and in some cases a differential diagnosisis impossible except by lumbar puncture. Marked diarrhea, eventhough the stools are not characteristic, should always make one doubtmeningitis. A diagnosis between the different varieties of ileocolitis
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