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PubMed1976

Leukocyte migration inhibition by a specific antigen in human typhoid fever.

Cellular reactivity to heat-killed Salmonella typhi antigen was investigated by the leukocyte migration inhibition (LMI) method in 33 S. typhi infected patients and in 32 control persons. In the typhoid group a statistically significant LMI was observed as compared to the members of the control group. A correlation was found between the level of the cellular sensitivity and the time elapsed between onset of the disease and performance of the test. Previous typhoid vaccination had no influence on the LMI. No correlation was found between the agglutinin titres and the sensitivity demonstrated by the LMI test. The value of the method in studies of cellular immunity in typhoid fever is discussed.

Agglutinins↗
PubMed1999

Characterization of a phase 1-d epitope on Salmonella typhi flagellin and its role in the serodiagnosis of typhoid fever.

A monoclonal antibody (MAb) directed against Salmonella typhi 52 kDa flagellin protein has been previously produced by our group. In this study, we have demonstrated that the epitope specific to the MAb is unique to phase 1-d. To map the epitope, plasmids encoding different regions of S. typhi flagellin gene were constructed. Analysis of protein produced from each recombinant plasmid indicated that the epitope specific to the MAb resided within amino acids 171-303 (region IV) of S. typhi flagellin protein. The recombinant region IV flagellin was used to develop an ELISA for the detection of IgM antibody to S. typhi in serum. In the hemoculture-positive typhoid group, the developed ELISA was positive in 77 of 92 cases. In patients with non-typhoidal Salmonella, gram-positive and gram-negative bacteria or dengue virus, the ELISA was negative in all 78 cases. Two from 116 healthy control subjects had positive reactions with the assay. The calculated sensitivity, specificity, positive and negative predictive values of the test were 83.7%, 99.0%, 97.5% and 92.8%, respectively. With such high validity together with the requirement of only a single serum specimen and one day for performing the test, the developed ELISA should become a valuable diagnostic test for typhoid fever.

Antibodies, Monoclonal↗
PubMed1999

Orelox (cefodoxime) in typhoid fever.

OBJECTIVE: To study the efficacy of Orelox (Cefodoxime) in Typhoid fever in children. SETTINGS: Open, non-comparative, multicentre study carried out in GP settings in various cities of Pakistan. PATIENTS: Children aged 1-15 years were included in the study. Positive Widal test was the only diagnostic inclusion criteria. RESULTS: Four centers participated in the study. Of the total 77 patients (51 males and 26 females), 61 (79%) cured, 5 (7%) improved (less severe signs and symptoms) and 11 (14%) failures. CONCLUSION: Treatment of typhoid fever in this study showed 86% efficacy in producing clinical responses suggesting that this drug can be effectively and safely used in the treatment of typhoid fever in children.

Adolescent↗
PubMed1978

Enteric infections in Singapore with special reference to typhoid.

A review of the epidemiological features of the more important enteric infections in Singapore was given. Enteric fevers (typhoid and paratyphoid), Salmonella gastroenteritis and Shigellosis remained endemic at a rather constant level in spite of vast improvement in environmental sanitation, but amoebic dysentery showed marked decline. Vibrio parahaemolyticus is an important cause of food poisoning since it was first reported in 1973. El tor cholera is believed to be introduced through regional trade and travel. Control measures directed mainly at typhoid include detection of typhoid carriers in the community responsible for transmission of infection, control and licensing of public food handlers and health education.

Adolescent↗
PubMedDate not supplied

[Acute pancreatitis secondary to typhoid fever in a preschool child].

INTRODUCTION: A case of child with acute pancreatitis associated with typhoid fever is reported herein. CASE REPORT: A four years old child was admitted to the pediatric emergency room with an acute abdomen and fever. He was submitted to a diagnostic laparotomy and mesenteric adenitis was the only finding. During the postoperative period, he persisted with abdominal pain and fever. Laboratory studies and abdominal ultrasonography revealed an acute pancreatitis. Also, Salmonella typhi was isolated from blood and stool cultures. Treatment for pancreatitis included nasogastric catheter and total parenteral nutrition. Typhoid fever was treated with ampicillin. Thereafter, his clinical course was uneventful and he was discharged 13 days after being admitted. CONCLUSIONS: Acute pancreatitis has been associated with typhoid fever. To the best of our knowledge, this is the youngest patient reported in the literature with this association. Possible pathophysiologic mechanisms are reviewed.

Abdomen, Acute↗
PubMed2001

Comparison of safety and immunogenicity of a Vi polysaccharide typhoid vaccine with a whole-cell killed vaccine in Malaysian Air Force recruits.

OBJECTIVE: To carry out a comparative study of the safety and immunogenicity of Vi polysaccharide vaccine against whole-cell killed (WCK) typhoid vaccine. METHODS: The study was carried out on young adult recruits (aged 18-25 years) of the Malaysian Air Force. A total of 125 subjects received the Vi polysaccharide vaccine and 114 received the WCK vaccine. FINDINGS: The Vi vaccine was significantly less reactogenic than the WCK vaccine with regard to systemic and local reactions. Following administration of the Vi vaccine, seroconversion rates (defined as the percentage of subjects with a 4-fold rise of baseline antibody level) of 75.5% and 67% were observed at 2 weeks and 6 weeks, respectively, after immunization, compared with 25% and 31.3% among recipients of the WCK vaccine. Of the 110 Vi vaccinees with serological data, 21 (19%) had high, seroprotective, pre-immunization levels of anti-Vi antibodies (> or = 1 microgram/ml). The majority of subjects in this group came from a region in Malaysia which is known to have high typhoid endemicity. Interestingly, these antibody levels were boosted considerably following administration of vaccine at a level that was 5-fold higher than in subjects with low pre-immunization levels. In contrast, the seroconversion rates in those receiving the Vi vaccine were higher in subjects with low pre-immunization levels of anti-Vi antibodies (76-84%), compared to those with protective levels of > or = 1 microgram/ml prior to immunization (48-57%). CONCLUSIONS: The study reaffirms the safety and efficacy of the Vi polysaccharide vaccine and identifies a hitherto unrecognized advantage in its use, i.e. it is a potent immunogen that boosted considerably the protective antibody levels among a significant number of immunologically sensitized individuals living in typhoid-endemic regions.

Adolescent↗
PubMed1975

Investigation of the role of Vi antibodies and antibodies of IgA type in the low specific bactericidal activity of the serum in typhoid carriers.

Absorption of sera of typhoid carriers with Vi antigen resulting in the decrease of gamma A antibodies led to a significant increase in the specific bactericidal activity of the serum. On the basis of these findings the authors discuss the origin and the cause of the low values of this activity in sera of typhoid carriers and the possible meaning of this phenomenon in the pathogenesis of typhoid carriership.

Antibodies, Bacterial↗
PubMed2001

[Diagnostic, therapeutic and prognostic aspects of intestinal typhoid perforations in children of Abidjan, Côte d'Ivoire].

We conducted a retrospective study on 48 children (with a sex ratio of 22 males to 26 females) who had been operated over the preceding 10 years for typhoid perforation on the viscera ward within the paediatric surgery department of Yopougon teaching hospital in Abidjan, Côte d'Ivoire. The mean age was 9 years 3 months ranging from 3 to 16 years. Typhoid peritonitis was diagnosed on the basis of symptoms, intestinal injuries and only rarely by way of biological examinations. Medical treatment associated three antibiotics: aminosid, metronidazol and the third generation of cephalosporin. Hydroelectrolytical and haematological resuscitation was performed 3 to 6 hours before laparotomy. Excision-suture was made in 81% of cases. Exclusive parenteral nutrition began 48 hours after the laparotomy. Mortality occurred in 6% of patients and morbidity in 46%. Complications were parietal suppurations, digestive fistula, parietal hernia, early occlusive syndromes and necrosed cholecystisis. Rectorragy and leucocytosis were considered as pejorative signs when associated to the classic typhoid peritonitis.

Adolescent↗
PubMed1975

[Study of the process of interaction of the causative agent with the cells of the body and with a macrophage culture in experimental typhoid infection and carrier state].

Experiments were conducted on 117 rabbits and cells of the macrophage cultures in vitro by the methods of clinico-laboratory, quantitative microbiological, immunological, electron microscopic and microcinematographic examination; a study was made of the interaction of the typhoid causative agent with the cells of the organism and the macrophage cultures and also of some aspects of the immune response during acute typhoid infection and carrier state. Infection was modelled by the enteral, subconjunctival and intrabonemarrow infection with 24-hour culture of the typhoid bacillus (strain Ty2 4446). Experiments demonstrated that structural reconstruction of both the causative agent and of the cells of the organism, of the culture macrophages and their organoids occurred in the course of the first hour after the infection. Homogenates of the lymphoid and myeloid tissues and also of the macrophages and polymorphonuclears possessed bactericidal activity against S. typhi. The degree of this activity largely depended on the pH of the medium. It was also shown that under conditions of the macrophage culture sodium aside inhibited the bactericidal activity of macrophages obtained from the intact and immune animals.

Acute Disease↗
PubMedDate not supplied

[Typhoid fever and Salmonella gastroenteritis in children (author's transl)].

A study on 25 hospitalized children with salmonellosis in the two forms of typhoid fever and gastroenteritis is reported. It confirms the higher incidence of gastroenteritic forms under the age of 3 years, and of typhoid fever in older children. We verify the limited value of the white cell count and the enlargement of the spleen. An appraisal of the serologic tests is made. The direct relationship between group D salmonella and typhoid fever form is pointed out. Finally we analyze the action of ampicillin, chloramphenicol and trimethoprim-sulphamethoxazole, due to the current appearance of resistances to antibiotics.

Agglutination Tests↗
PubMedDate not supplied

[Acalculous acute cholecystitis during the course of typhoid fever in children].

OBJECTIVES: Determine the treatment of the acalculous acute cholecystitis during the course of typhoid fever in children. MATERIAL AND METHODS: It was carried out a retrospective study in 10 patients with acalculous cholecystitis in the course of typhoid fever, from June 1992 to May 1997, in the Children's Institute of Health. RESULTS: Six patients were male and four women, whose ages fluctuated among the 2 years 6 months old to 15 years old. Cholecystitis was presented mostly in the first weeks of the illness. Characteristic findings were fever, abdominal pain, diarrhea, vomits, jaundice and palpable mass. We have performed cholecystostomy in four patients, cholecystectomy in 3 patients and three patients were not operated, two then received medical treatment and were follow-up with ultrasonography and one patient got lost in the control. The 10 patients received chloramphenicol for 14 days. As post operative complication, a patient presented an intestinal obstruction for adherences and another patient presented an intraabdominal abscess. CONCLUSION: Acute cholecystitis is not a common entity in children, and rare complication in the course of the typhoid fever. The surgical decision is primary in almost all the patients, for the risk of vesicular perforation and the possibility they become healthy carriers. Those patients who were not able to have a surgical treatment, were recommended to have medical treatment and ultrasonographic follow-up.

Abdomen, Acute↗
PubMedDate not supplied

Retrospective analysis of typhoid fever in a tropical tertiary health facility.

A retrospective analysis of cases diagnosed as typhoid fever over a ten-year period at the University College Hospital, Ibadan, Nigeria was carried out to assess the presentation pattern, laboratory investigation, mortality and mode of therapy. Incidence was of typhoid fever was highest in the dry months of the year. The mean age of survivors and the dead are 25.7 and 21.9 years respectively. Most of the patients presented with fever, abdominal pains and other gastrointestinal symptoms such as vomiting, constipation and diarrhoea. There was no specific temperature pattern but pulse rate > or = 120/minute was significantly associated with mortality. The commonest complication was intestinal perforation followed by haemorrhage with septic shock playing a prominent role in mortality. Mortality rate of 22.2% was recorded which is not significantly different from the 24% recorded at the same centre over three decades ago and most of them died within nine days of admission with 50% dying within 3 days. Most patients were scantily investigated with poor yield on blood, stool and urine cultures. Widal's test was not a favoured investigation and was not helpful in diagnosis. Chloramphenicol was the drug of choice as monotherapy, while metronidazole and gentamicin were used in cases of gut perforation. It is concluded that typhoid fever is still a major health concern in the tropics and efforts need to be geared up to combat this preventable scourge by improvement in basic necessities of life such as potable water, hygienic food in addition to health education.

Adult↗
PubMed2002

Typhoid hepatitis.

Though typhoid fever is quite common, typhoid hepatitis is a very rare entity which may have a variety of presenting features similar to other more common conditions. One case of typhoid hepatitis is reported here because of its ratity.

Adolescent↗
PubMed2002

[Diagnostic difficulties in febrile travellers returning from the tropics. Two cases of typhoid fever imported from India].

Typhoid fever is an acute infectious disease caused by Salmonella enterica serotype typhi. The infection is responsible for endemic or epidemic outbreaks in tropical and subtropical countries, especially in Indian subcontinent, Southeast Asia, Central and South Africa. Latin America, and it occurs sporadically in Poland. We reported two cases of imported typhoid fever after travelling to India and Nepal. In the tourists returning from the area hyperendemic for malaria, visceral leishmaniosis, amoebiasis and haemorrhagic fevers and not following tropical hygiene measures, persistent fever was a source of difficulties in differential diagnosis. In the first case, lack of anti-malarial chemoprophylaxis in the presence of anaemia and thrombocytopenia strongly suggested Plasmodium spp. infection. Two daily peaks of fever with splenomegaly, lymphadenopathy, leucopenia, high transaminases levels and co-existing positive serology for L. donovani pointed to visceral leishmaniosis. Late occurrence of specific anti-S. typhi agglutinins in the Widal test, cross-reactivity with S. paratyphi A and negative urine bacteriological culture were observed. In the second case, gastrointestinal disturbances, including pain, abdominal tenderness and diarrhoea gave a suspicion of amoebic colitis. Stool and urine cultures were negative for S. typhi and cross reactions with S. paratyphi A and C were reported. Typhoid fever was finally confirmed in both patients by an isolation of S. typhi from peripheral blood cultures. The effectiveness of treatment of choice with ciprofloxacin or ceftriaxone in a case of multidrug-resistant (MDR) strain of S. typhi was documented.

Abdominal Pain↗
PubMed2003

[Changes in hemograms of patients with epidemic typhoid].

In typhoid epidemy in Tadjikistan we studied hemograms obtained in 200 patients and 100 healthy controls matched by age. Though hematological shifts are considered to be typical of typhoid, most of the patients had no hematological disorders despite their severe condition. Hemograms were normal in half of the patients at the height of typhoid while other patients often (40-43%) had accelerated ESR, uneosinophilia and left shift of immature neutrophils.

Blood Cell Count↗
PubMed2003

Acceptability of oral typhoid vaccine in Thai children.

To determine the acceptability of oral typhoid vaccine to Thai children, 434 volunteers, aged 4-15 years (average age = 8.2 years), were assigned to take three capsules of oral typhoid vaccine (one capsule every other day). Success was defined as the subjects' being able to swallow all three capsules. Information concerning the subjects' level of education, eating habits, and ability to take medicines in a variety of preparations (syrups, tablets and capsules) was obtained. The overall success rate was 94.2%; the rates were 84.4%, 94.9%, and 100% in the age groups 4-6 years, 7-9 years, and 10-12 years respectively. The rates were 82%, 85.7%, 93.3%, 96.4%, 98.8%, 100% and 100% in the students of kindergarten 1, kindergarten 2, elementary grade 1, grade 2, grade 3, grade 4, and grade 5 respectively. There was a correlation between a child's prior ability to take tablets/capsules and his success in swallowing the oral typhoid vaccine.

Administration, Oral↗
PubMed1992

[Study of the Widal test phenotypic expression of blood groups ABO, Rh and MNSs in patients with typhoid fever].

The significance of the Widal test (WT) as a phenotypical expression was investigated in a cross-sectional study of 244 children from the Northern Area of Santiago (Chile) with bacteriologically confirmed typhoid fever (TF) due to S. typhi (183 cases) and S. paratyphi B (61 cases). The working hypothesis was that if the parasite-host relationships were similar for these two agents the immune response, as measured by the Widal test, should be similar. An association between test response and etiology was found consisting of a significantly higher proportion of positive response, in cases due to S. paratyphi B as compared with those due to S. typhi, (OR = 2.13; 95 Cl% = 1.06, 4.32; p = 0.02). Stratified analysis showed that although the association between etiologic agent and Widal test response persisted within all strata, significant interactions could be shown as evidenced by the magnitude of the associations, which varied according to blood phenotypes as well as gender (Mantel-Haenszel test for heterogeneity for 0, p < 0.034; for RH5 p < 0.033; for SS, ss p < 0.056; and gender p < 0.033). These results support the hypothesis that the Widal test response is a phenotypical marker eventually useful for studying human genetic heterogeneity in typhoid fever. The implications of these findings regarding previous study results and the possible role of S. paratyphi B in typhoid fever and its related conditions are discussed.

Adolescent↗
PubMed1976

[Phage-typing of typhoid cultures and results of use of this method in anti-epidemic practice in the Azerbaijan SSR].

This work was aimed at the study of the phage-type pattern of the causative agents of typhoid fever isolated in the Azerbaijan SSR in 1960-1973. As revealed, the following 26 phage-types circulated in Azerbaijan during the period under study: A, B1, B2, B3, C1, C4, C5, D1, D2, D4, D8, E1, E2, E3, E5, F1, F2, I1, M1N, T, 28, 38, 39, 40 and 46. The most widespread were phage-types A (22.86%), E1 (13.96%), F1 (9.74%), F2 (6.70%), and 28 (5.71%) constituting over half of the typed typhoid strains. Sources and ways of transmission of the infection were deciphered with the aid of phage-typing typhoid cultures.

Azerbaijan↗