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PubMedDate not supplied

Changing trends in outcome of typhoid ileal perforations over three decades in Pondicherry.

Two hundred and forty eight cases of proved typhoid ileal perforation were admitted and treated in three phases in the department of surgery during 1966-1998. Of these, 71% patients belonged to second and third decades of life. Male female ratio was 4:1. Abdominal pain (100%) fever (95%) and constipation (87%) were the main presenting symptoms. Abdominal guarding and rigidity (84%) were the principal physical signs. Plain radiograph of abdomen showed evidence of pneumoperitoneum in 57% of cases. The Widal test was positive for S. typhi in 74% of cases. Blood and bone marrow culture were positive for S. typhi in 9% and 30% respectively. Histology of the excised edges of perforation confirmed typhoid pathology in 62% of specimens. Many of the patients were treated conservatively in the first phase. In phase two and three vigorous resuscitation and early surgery was resorted to. Simple closure in two layers and wedge resection were the treatment of choice in most of the cases. Bypass, ileostomy and resection were done on few occasions. Chloramphenicol was the only drug used in the first phase. Other broad spectrum antibiotics were added to chloramphenicol with metranidazole in the second phase. Ciprofloxacin and metronidazole were the drugs of choice in the third phase. The mortality rate showed a dramatic improvement from 47.2% (first phase) to 17.7% (second phase) and as low as 7% in the last phase. The lag period (advent of symptoms to time of admission to hospital) showed definite correlation with mortality. Septicemia, wound infection, dehiscence, enterocutaneous fistula were the principal postoperative complications.

Female↗
PubMedDate not supplied

[Specific features of the typhoid fever epidemic process in organized collective].

During the chronic water epidemic of typhoid fever in Tajikistan in 1996-1997 specific features of the epidemic process dynamics in groups of servicemen were studied in several cities. The infective agent was proved to be transmitted by the alimentary route and through everyday contacts, the water route of transmission playing the most important role. The early clinical and epidemiological signs of the water outbreak of typhoid fever and the risk factors were established. The clinical and epidemiological aspects of vaccination were analyzed.

Community-Acquired Infections↗
PubMed1975

Typhoid polymyositis.

Four patients with typhoid polymyositis, 3 of whom were members of one family, are described. There was clinical, biochemical and histological evidence of severe muscle involvement which reversed on treatment with Chloromycetin. Muscle involvement in typhoid fever is a recognised pathological entity, but a clinical syndrome involving muscle has not previously been described.

Adolescent↗
PubMed1979

Development of specific cellular immunoreactivity in typhoid fever.

Development of cellular immunoreactivity to Salmonella typhi and Salmonella paratyphi-A was studied by the leukocyte migration inhibition test in 9 patients with typhoid fever and in 2 patients with paratyphoid fever. Cellular reactivity could be demonstrated from the first days of the disease in all the subjects. The most pronounced migration inhibition was observed during the febrile period. It is suggested that specific cellular reactivity may play a pathogenetic role in typhoid fever.

Adult↗
PubMed2002

[Typhoid fever. Retrospective study of 52 cases in Lebanon].

OBJECTIVE: Present the epidemiology and clinical characteristics of typhoid fever in the Lebanon. METHODS: Retrospective study of 52 patients admitted to a university hospital center between 1995 and 1999. The criteria for inclusion were a positive Salmonella typhi or paratyphi hemoculture and/or Widal serodiagnosis > 1/160 for O agglutinin, in the presence of evocative symptoms. RESULTS: The patients were aged a mean of 31 +/- 24 years. The mean duration between the onset of fever and diagnosis was of 10 +/- 8 days. Fever was observed in 96% of cases and the other predominant symptoms were diarrhea (37%), abdominal pain (31%) and headache (29%). Feverish gastroenteritis is a frequent manifestation in children (61% of cases). Complications were noted in 33% of cases and were predominantly digestive. Leukopenia is not a good diagnostic marker. S. typhi was the cause in 83% of cases. Resistance to ampicillin was noted in 13% of cases, to cotrimoxazole and to chloramphenicol in 10% and to ofloxacine in 3% of cases. One death was reported (2%) of an immunodepressed patient. CONCLUSION: Typhoid fever is still an endemic disease in the Lebanon and should be systematically evoked in the case of prolonged fever, feverish gastroenteritis and/or headache. The appearance of bacteria resistant to antibiotics makes ceftriaxone or ciprofloxacine the empirical treatment of choice.

Abdominal Pain↗
PubMedDate not supplied

[Studies on the relation between the production of anti-O and anti-H agglutinins and the specific treatment of typhoid fever].

The AA, studied the behaviour of anti-O and anti-H agglutinins in patients with typhoid fever treated with CAF or with CAF+ corticosteroides. They have shown that, during the treatment with antibiotics, the O-agglutinins, which appeared extremely quickly, can be present at a high level and for a long time in the serum; on the other hand the H-agglutinins are usually present at a lower level and tend to decrease more rapidly. In patients treated with CAF+ corticosteroides the agglutinins behaviour was not substancially different from that in patients treated with antibiotic only. These modifications in humoral immunity are notable only when treatment is begun early. On the basis of the results and of data in the most recent literature, the AA. also discuss the problem of typhoid relapses, the pathogenesis of which cannot depend from the modifications of humoral immunity only.

Adolescent↗
PubMed2002

[Typhoid fever and pregnancy].

Typhoid fever is rare in Europe, but well-recognized endemic disease in tropical zones. We report our findings in a series of 25 cases of typhoid fever during pregnancy observed in French Guiana and reviewed the literature on clinical signs, diagnosis and treatment. Salmonellea typhi causes septicemia of digestive origin that can cross the placenta resulting in chorioamniotitis. Maternal-fetal infection with S. typhi can lead to miscarriage, fetal death, neonatal infection, as well as diverse maternal complications. In order to avoid maternal complications and possible fetal transmission, treatment with ceftriaxone should be initiated as early as possible

Abortion, Spontaneous↗
PubMed2002

Typhidot test to detect IgG & IgM antibodies in typhoid fever.

BACKGROUND & OBJECTIVES: As typhoid fever is endemic in India, there is a continuing search for a simple test which can be carried out in small laboratories for an early and rapid diagnosis. We have evaluated the Typhidot test for this purpose. METHODS: The Typhidot test was carried out on coded sera according to the manufacturer's instructions. The test was performed on 30 Widal positive sera, 30 sera from blood culture positive patients, 60 Widal negative sera and 30 samples from patients whose blood culture grew Gram negative bacilli (GNB) other than Salmonella Typhi. RESULTS: Typhidot test was positive for both IgG and IgM in 39 samples, IgM alone in 24 and IgG alone in 2. Of the 30 culture positive samples, 27 were positive by Typhidot. The Typhidot test gave a sensitivity of 100 per cent and specificity of 80 per cent when bacteraemic patients were analysed. INTERPRETATION & CONCLUSION: The Typhidot is easy to perform, and requires no special equipment or training of staff for interpretation of results. It will be a useful complementary test to blood culture and the Widal test in the diagnosis of typhoid fever.

Antibodies, Bacterial↗
PubMed2003

[Typhoid fever epidemic in Ahmetli village, Diyarbakir-Ergani].

Salmonella typhi leads to typhoid fever outbreaks due to the contamination of drinking water. In this study, a typhoid fever outbreak due to drinking water contamination in Ahmetli village, Ergani-Diyarbakir, in the period of December 25, 2001-January 4, 2002 was evaluated. A total of 181 suspicious cases were admitted to different health care centers during the outbreak and 71 (39.2%) of them were hospitalized. Gruber-Widal test could be performed for only 8 hospitalized patients, and were found positive in 6 of them. S. typhi was isolated from 3 of the 26 blood cultures and two of the 73 stool cultures of the patients. All village inhabitants were visited and suspicious cases were screened for salmonellosis. It was shown that the village-drinking water was contaminated with sewage. No S. typhi was isolated from the drinking water since it was previously disinfected. Maintenance of drinking water supply system, individual chloride usage and education were recommended, as safety cushions.

Adolescent↗
PubMed1992

Typhoid fever complicated by chloramphenicol toxicity, ataxia and psychosis.

A case of typhoid fever complicated by pancytopenia, cerebellar signs and psychosis is described. The association of reversible marrow suppression with chloramphenicol treatment and its clinical features are outlined. The features of cerebellar dysfunction and of psychosis in patients with typhoid are described. Recommendations are made to help identify the problem of chloramphenicol-induced marrow suppression when it occurs.

Adult↗
PubMedDate not supplied

Clinical trial of sulbactam/ampicillin in the treatment of typhoid fever, and in-vitro sensitivity of isolates to sulbactam/ampicillin and chloramphenicol.

A trial of Sulbactam/Ampicillin in treatment of typhoid fever was carried out while in-vitro sensitivity of the drug was compared with chloramphenicol. Sulbactam/Ampicillin was found to be effective in 11 out of 12 patients who received the drug. The 1 patient who failed to respond had intestinal perforation with peritonitis. No side effects were encountered. The in-vitro study showed that 91.7% of the isolates were sensitive to sulbactam/ampicillin compared to 75% sensitivity to chloramphenicol. The difference was however not statistically significant (P < 0.05). It is concluded that sulbactam/ampicillin is effective and safe in the treatment of typhoid infection.

Adolescent↗
PubMed1992

[Typhoid fever in children: association with blood phenotypes ABO, Rh and MNSs].

The hypothesis that blood phenotype B is associated to typhoid fever either directly or interacting with other phenotypes of the Rh or MNSs blood systems was tested. 256 children from the Northern Area of Santiago (Chile) with bacteriologically confirmed typhoid fever and 329 afebrile controls matched by age and gender from the same population, were studied. Association was found between phenotype RH3 and protection against disease for the whole group (OR = 0.67; p < 0.042) and for males (OR = 0.05; p = 0.014) although the gender-RH3 interaction was at the limit of significance. RH8 and Ss phenotypes were associated to increased susceptibility (OR = 1.83; p < 0.034 and OR = 1.56; p = 0.01, respectively). Controlling RH3 and Ss phenotypes by B, increased their effects (OR = 0.26; p = 0.04 and OR = 3.42; p = 0.026, respectively), but interactions did not reach statistical significance. These results show a susceptibility cline whose implications and applicability deserve further studies. A high proportion of S. paratyphi B (23.8%) appeared in this series, which may imply sample heterogeneity. The meaning of these findings need further epidemiological and genetic studies.

Blood Group Antigens↗
PubMed2003

[Efficacy of various antimicrobial agents in the treatment of epidemic typhoid fever].

During superepidemic of a typhoid fever in Tadjikistan the efficiency of application in clinics and of 14 antimicrobial agents representing almost all basic chemical classes was investigated. Remarkable variation of frequency and type of S. typhi resistance to these preparations up to epidemic and especially in its process was demonstrated. The absence of absolute (100%) efficacy of the investigated agents in vivo and in vitro was shown. The reasons of low efficacy of etiotropic treatment of the patients with typhoid fever are analysed.

Adult↗
PubMed1992

Childhood typhoid fever diagnosed in an urban U.S. setting.

The majority of cases of childhood typhoid fever diagnosed in the United States occur in persons recently returned from travel abroad. We report two childhood cases of typhoid fever acquired in Mexico and India and diagnosed in an urban United States setting. This report describes these cases and provides insights into the pitfalls in recognizing this condition in a nonendemic setting as well as information concerning differential diagnosis and treatment.

Adolescent↗
PubMed1992

The white cell count in typhoid fever.

Leucopenia with neutropenia and a relative lymphocytosis are believed to be common findings in patients with typhoid fever. This paper reviews 191 adult patients with typhoid. The total and differential leucocyte counts done on admission were analysed. In this study leucopenia was found in only 24.6% of patients. Whilst complications occurred at any white cell count, the prevalence of complications increased significantly to 70% in patients with a white cell count above 8 x 10(9)/l. Neutropenia was found in 25% of patients, and none of the patients had an absolute lymphocytosis, whereas 75.8% of patients had true lymphopenia.

Adult↗
PubMed1992

[Incidence of typhoid fever in our environment. Analysis in Guipúzcoa].

Based in 184 cases of Typhoid Fever bacteriologically demonstrated in the past 14 years (greater than 90% of all cases registered in the whole province), we have observed that, with the exception of some epidemic outbreaks, the disease has been constantly present during all these years, with a higher incidence between August and November. Salmonella typhi infected primarily young adults, its distribution being similar to the one among the general population. 49% of cases were males. The estimated incidence rate of the disease during this period was 2-3 per 100,000 population. A seroepidemiological study among healthy women with ages between 20 and 40 years showed a seroprevalence of anti-H:d antibodies greater than or equal to 1/40 of 1%. Although the epidemiological situation of Typhoid fever in our environment is not as bad as it has been referred in reports and textbooks, an effort is needed to situate the problem at the appropriate level, given our geographical situation and our economical development.

Adolescent↗
PubMed1992

Multidrug resistant typhoid fever: therapeutic considerations.

Forty six blood culture positive cases were studied during the current outbreak of multidrug resistant typhoid fever (MRTF). The present outbreak was caused by E1 phage type and organisms were resistant to all commonly used drugs for the treatment of typhoid fever, viz., chloramphenicol (78%), co-trimoxazole (76%) and ampicillin (68%). Treatment failures with chloramphenicol (45.5%) corroborated well with in vitro resistance. No treatment failure was seen with chloramphenicol and ceftriaxone, when these drugs were used in cases infected with sensitive strains. Among the alternative drugs used in cases with in vitro sensitivity, successful clinical response was seen with ceftriaxone (4/4) and cefotaxime (8/9) as compared to cephalexin (3/5) or a combination of cephalexin and furazolidone (9/12).

Ampicillin Resistance↗
PubMed2004

[Typhoid fever in a child--a case report].

We report a case of typhoid fever in an 8 years old boy. The child was initially admitted to a local hospital where pneumonia, myocarditis with heart failure, pyelonephritis, liver and pancreatic failure as well as cholelithiasis were suspected. Zinaceff and Amikin were administered and after 8 days the child was referred to the cardiology department of a regional reference hospital due to heart failure symptoms. There the diagnosis of sepsis was established, and the antibiotics changed to Pipril and Amikin. The child however did not improve and after two days he was transferred to an intensive care unit. The previous anti-microbial therapy was continued for another 7 days until the results of stool culture revealing Salmonella sp. were available. Subsequently the boy was admitted to our clinic. Based on the clinical course, Widal test and isolating of the Salmonella typhi from the stool samples typhoid fever was diagnosed.

Child↗