Capillary Observations in Patients with Hemorrhagic Fever and Other Infectious Illnesses1

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Abstract
In order of frequency, decreased vasomotor activity, refractoriness to 1-norepinephrine, increase in mean widest diameter, and hemorrhagic diathesis were the outstanding features in the nailfold capillary bed during the febrile and hypotensive phases of hemorrhagic fever. These changes tended to parallel the severity of illness and were not mitigated by tetracyclines, benadryl, cortisone, or 1-norepinephrine. Constriction and heightened vasomotor activity subsequently appeared during the hypertensiveoliguric and diuretic phases of hemorrhagic fever. The capillary alterations are not peculiar to the nailfold, but reflect the presence of injurious factors acting diffusely and directly, though not uniformly, upon the capillary vascular system. Single patients with Rocky Mountain spotted fever, scrub typhus, and infectious mono-nucleosis exhibited capillary changes indistinguishable from those of the febrile and hypotensive phases of hemorrhagic fever. None of the other infectious illnesses studied, despite pyrexia to 105[degree]F, were associated with detectable capillary alterations.