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PubMedDate not supplied

Typhoid intestinal perforation in north central Nigeria.

BACKGROUND: Typhoid intestinal perforation is a surgical problem with severe morbidity and high mortality in North Central Nigeria. PATIENTS AND METHODS: In order to determine the pattern and the prognostic indices, we studied 101 patients with typhoid intestinal perforation managed over a ten-year period RESULTS: Children constituted 49% of the cases and majority (78%) of the patients were in the low socio-economic strata. The incidence peaked to 67% between November and March - the dry season in Nigeria. The male/female ratio was 1.9:1 with a mean age of 19 years and a mean hospitalization period of 18 days. There were 167 perforations; four involved the large bowel and appendix, and in 72.2% cases, the perforation was single. The mortality rate was 13.9%, affected mostly children and significantly worsened by prolonged perforation-surgery interval > 72 hours, jaundice, convulsion, ASA V, faecal peritonitis and re-exploration for early intra-peritoneal complications. Morbidity rate was 65.3% and significantly affected more children than adults and associated with perforation-surgery interval of between 24 and 72 hours, haematochezia and multiple perforations. Moribund patients fared better when operated upon under local anaesthesia with adequate analgesia. The least traumatic but effective surgical procedure that could seal the perforations and keep the peritoneum clean gave the best results. Children who survived up to 5 days and adults who survived up to 10 days after surgery had better chances of survival. CONCLUSION: The most significant prognostic factor is late presentation which prolongs perforation-surgery interval and the other complication and mortality indices are directly influenced by it.

Adolescent↗
PubMed1976

[A study of the avidity of Vi antibodies in typhoid fever patients and chronic carriers].

Avidity of Vi-antibodies was studied in the patients suffering from typhoid fever and chronic carriers in the indirect hemagglutination test (IHAT) by means of titration with erythrocytic diagnostic agents sensitized with various doses of the Vi-antigen. The minimal sensitizing dose still adequate for detection of the antibodies in the titre of 1 : 20 was accepted as the avidity index. By the avidity sign the antibody heterogeneity index was calculated as the ratio of the optimal sensitizing dose to the minimal sensitizing one. In comparison with the patients suffering from typhoid fever of at the acute period of the disease in chronic carriers Vi-antibodies were more avid, this being conditioned chiefly by the highly avid IgG-antibodies. During the acute period of the disease the avidity of Vi-antibodies elevated only against the antibodies of the IgG-class. An increase of heterogeneity by the same sign was noted with increase of the degree of the serum antibody avidity.

Antibodies, Bacterial↗
PubMedDate not supplied

The ideal treatment of the typhoid enteric perforation - resection anastomosis.

Eighty-one cases of typhoid enteric perforation were studied prospectively after separating them into four groups. Group A patients were treated with resection anastomosis, group B by debridement of margins of the perforation/wedge excision and simple closure, group C by simple closure and group D by ileostomy of perforated ileum or simple peritoneal drainage. A copious lavage of the peritoneal cavity with normal saline was performed in all four groups. The complication and mortality rates for group A patients were 37.50% and 21.47%, respectively, very much less than that observed in the other three groups. The ideal treatment for typhoid enteric perforation was found to be resection-anastomosis with copious peritoneal lavage.

Adolescent↗
PubMed1975

[Typhoid fever in south Vietnam to day (author's transl)].

In South Vietnam, the first Salmonella typhi resistant to chloramphenicol were isolated at the end of 1971; this resistance spread rapidly to two-thirds of S. typhi isolated; it is due to resistance plasmids which parasite most strains of S. typhi identified in Vietnam. The typhoid endemy turned into an epidemic en 1972. The clinical symptoms of typhoid fever remained just as few as before: often only a high temperature; splenomegaly is rare, hepatomegaly more frequent. Complications, specially associated ones, have been more frequently observed since 1972; the evolution of the disease is slower. Although costly, a high dose of ampicillin often proves clinically active. For the moment, an association of trimethoprime and sulfamethoxazole remains the least expensive of efficient treatments.

Adolescent↗
PubMed1999

[Typhoid fever in periods of wars and armed conflicts].

Study of military-epidemiological importance of typhoid-paratyphoid infections in military operations of XIX and XX centuries. Despite the research progress, and new means of special prevention, the problem has not been solved yet. In wars water becomes an important factor of typhoid spread in the troops and civil population, so water supply should be closely supervised by the civil authorities and military medics.

Global Health↗
PubMedDate not supplied

Acute respiratory distress syndrome complicating typhoid fever.

We report a case of a young female patient with typhoid fever whose clinical course was complicated by hypotension, thrombocytopenia, encephalopathy and acute respiratory distress syndrome (ARDS). She recovered with prompt mechanical ventilatory support. ARDS in typhoid fever has generally proved to be fatal in reported cases.

Adolescent↗
PubMed1999

Salmonella typhi VI antigen co-agglutination test for the rapid diagnosis of typhoid fever.

A slide Co-agglutination test for the detection of Salmonella typhi Vi antigen in blood was evaluated for its efficiency in rapid diagnosis of Typhoid fever. The results were compared with conventional methods like Blood culture and Widal test. The test showed a sensitivity of 86.67% and specificity of 88.83% when compared with blood culture positivity or Widal titre above 160. This is a useful rapid diagnostic test for the early diagnosis of Typhoid fever.

Adult↗
PubMed1975

Serum zinc, iron, and copper concentrations during typhoid fever in man: effect of chloramphenicol therapy.

In volunteers experimentally infected with Salmonella typhi, serum iron and zinc concentrations became significantly depressed and there was a concomitant rise in serum copper before the onset of overt clinical illness. However, after several days of fever and the initiation of chloramphenicol therapy, serum iron and zinc concentrations significantly increased. Additional studies--in volunteers with typhoid fever treated with chloramphenicol, in a volunteer with typhoid fever receiving cefazolin and gentamicin, and in untreated rhesus monkeys infected with Salmonella typhimurium--provided evidence that the increase in serum iron concentration during the febrile phase was the result of chloramphenicol therapy, whereas the increase in serum zinc concentrations was a disease-related phenomenon. The importance of trace-metal monitoring during infectious disease and chemotherapy is discussed.

Adult↗
PubMedDate not supplied

Typhoid fever in children: a fourteen-year experience.

From 1982 to 1995, 71 children admitted in our medical center were diagnosed to have typhoid fever by culture or serology. Of the 71 children, most (83%) were aged 5-15 years. These children usually presented with fever and gastrointestinal symptoms, including abdominal pain, diarrhea, nausea or vomiting, and constipation. Hepatosplenomegaly was the most common physical sign observed and abdominal tenderness ranked the second. Thrombocytopenia occurring in 9 patients (13%) was the most common mode of complication. Other complications included intestinal perforation (3%), rectal bleeding (3%), ascites or pleural effusion (4%), and meningitis (1%). The incidence of complications tended to be higher among children 5 years of age or older (p = 0.31). Most patients responded well to appropriate antimicrobial therapies. There was no mortality. Relapse was observed in two children, although both had received 10 days of chloramphenicol therapy. The clinical isolates of Salmonella typhi were susceptible in vitro to all the antibiotics tested, including chloramphenicol, which, however, showed a higher MIC90 level than other drugs tested. In conclusion, there were age-specific differences of typhoid fever in children in terms of the incidence and morbidity and antibiotic resistance of S. typhi has not been a problem in this area at least up to 1995.

Adolescent↗
PubMed1979

[Analysis of the trends in typhoid-paratyphoid morbidity in the USSR].

Mathematico-statistical analysis of typhoid-paratyphoid infection morbidity in the USSR during 1900--1940 revealed a regular many-year cyclic recurrence of the changes in the morbidity level. The intensity of the morbidity level reduction at the periods of decline--in 1900--1917, 1920--1928, and in 1932--1939--was similar. A successive reduction of morbidity of this group of infections, by 6.45% on the average, annually, occurred in 1930--1976. The character of reduction of typhoid-paratyphoid infections morbidity level in the USSR during that period is well described by the exponential function.

Disease Outbreaks↗
PubMedDate not supplied

[Typhoid and paratyphoid fever in adults in the Internal Medicine Department at Libreville (Gabon)].

We carried out a retrospective study of 150 files of patients suffering from typhoid or paratyphoid fever, confirmed bacteriologically, between January 1992 and December 1996 at Libreville. Young adults were the most frequently affected. These infections were associated with unstable living conditions and lack of cleanliness. Neurological (17%), digestive (12%) and cardiovascular (3%) complications were the principal factors aggravating the disease. The following serotypes were identified: Salmonella typhi (47%), S. paratyphi B (25%), S. paratyphi C (20%) and S. paratyphi A (8%). Salmonellosis was associated with schistosomiasis (13%), nematodiasis (2.3%), sickle-cell anemia (7%) and HIV infection (8%). The mortality rate was 3.3%. Fluoroquinolones are the molecules of choice for treating typhoid and paratyphoid fevers.

Adolescent↗
PubMed2000

[Spatial and temporary changes in sensitivity of murine proliferative system and energy exchange to typhoid fever infection].

The authors studied the spatial and temporary organization of the proliferative system and energy exchange in the small intestinal epithelium, as well as spatial and temporary changes in the sensitivity of these systems in mice to typhoid fever infection (cultured Salmonella typhi, 4446) at day and night. The small intestinal epithelial systems were found to show a spatial and time organization and a close correlation between their temporary and spatial changes after infection. The temporary organization of the proliferative system in the esophageal epithelium is more sensitive to infection in the day-time and that of the small intestinal epithelial proliferative system is more marked at night. Thus, these changes are tissue-specific. Typhoid fever infection causes a negative effect on the proliferative system of the small intestine at night and on its energy exchange in the day-time, which shows the system-specific response of the temporary organization of a biological process within the same organ. The changes in the spatial proliferative and energy exchange parameters in the small intestinal epithelium, which have been caused by the infection of animals, depend on the time of a day.

Animals↗
PubMed1975

[Utilization of a solid nutrient medium for the serological method of detecting the causative agent of typhoid in patients' feces].

The causative agent of typhoid fever can be revealed in feces of patients not only by the bacteriological, but also by the serological method, if the material is preliminarily grown on hard nutrient media; Ploskirev's medium proved to be the optimal. It is suggested that microbial cultures left on the ager in Petri dishes after the bacteriological study should be used for bacteriological analysis. In a number of cases it was possible to reveal the causative agent of typhoid fever in feces by the serological method, although no coproculture was isolated bacteriologically.

Antigens, Bacterial↗
PubMed1975

Typhoid perforation of the ileum: A therapeutic dilemma.

Thirty-eight cases of typhoid perforation of the terminal ileum were encountered during a three-year period. Fourteen cases were treated conservatively, with a mortality of 36%. During the same period, the surgical mortality improved from 50% in 1972 to 11% in 1974. It is recommended that typhoid perforation be treated by operation.

Adolescent↗
PubMed2001

Studies on patients with Schistosomiasis mansoni, HCV and/or typhoid fever.

Two groups of patients were studied. First one included 50 schistosomiasis mansoni patients, 30 with simple infection, 10 with splenomegaly and with ascites. Second group included 111 patients of whom 20 with pure S. mansoni, 27 with pure HCV infection, 54 with mixed infection of schistosomiasis and HCV and 10 with schistosomiasis, HCV and typhoid fever. Serum transaminases and anti-HCV antibodies performed, showed anti-HCV raised levels in 10% of simple schistosomiasis, 60% in splenomegalic patients, 80% in ascites patients, and 7.1% in controls. Liver function tests in first group were within normal range except in those with ascites. In second group, liver function tests was norma in pure schistosomiasis patients, in pure HCV patients serum bilirubin was normal in 22.2%, AST, ALT and alkaline phosphatase were higher. In mixed infection, serum bilirubin was normal in 18.5%, serum transaminases were higher and alkaline phosphatase was normal among 77.7%. Patients with typhoid fever, HCV and schistosomiasis (12.6%) showed significant increase of liver function as compared with each of pure HCV or HCV and schistosomasis. Results were discussed.

Adolescent↗
PubMed1975

Operative management of typhoid perforation in children.

Nine children admitted with typhoid perforation of the ileum underwent a modified ileostomy procedure. The following conclusions were drawn: 1. X-rays do not help in diagnosis in the majority of cases. 2. Blood urea is raised in almost all cases and vigorous attempts should be made to bring its level to normal before operation. 3. Leukopenia does not exist in patients with typhoid perforation; leukocytosis is the usual finding. A positive Widal test is not generally found in these cases and positive blood cultures should not be expected. 4. Ileostomy through the site of perforation, as described, is a simple, safe and short operation in a critically ill patient with a necrotic bowel. Also, resuscitative drugs are not needed.

Child↗
PubMed1996

[The fight against dysentery, typhus and typhoid by Polish underground between 1941-1944].

Between 1941 and 1944 the Polish Home Army sanitary service was well prepared for the fight against infections diseases. The underground in so called General Government was both well organised and unimerous (nearly 350,000). The medical staff consisted of army doctors not taken prisoner, and civilians who as reserve officers were sworn to serve in the Home Army. Students from both elementary and secondary schools acted as undercover nurses having been prepared for the job by girl guides organisation. The main infections diseases were dysentery typhus and typhoid. Other diseases were rather rare during the World War Two. Since majority of population had been inoculated, the partisans needed only boosters. The typhoid spread in winters of 1941-42 and 1942-43 to the cast of the Vistula. Infections centres were isolated yet only the German part of population was inoculated by Weigl method. Since the vaccine was both expensive and hard to get only the Polish a staff officers of the Home Army and some doctors were inoculated. The epidemics of dysentery was particularly dangerous in August and September 1944 in the Kampinos Group during the Warsaw Uprising. In the barns of six villages in Kampinos there were 1190 sick partisans. Small amounts of medicines were parachuted by Polish Air Force from Italy. Therefor the chief medical officer recommended each patient drink a glass of bovine blood daily. This decreased mortality to nearly a zero.

Communicable Disease Control↗