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Serum zinc, iron, and copper concentrations during typhoid fever in man: effect of chloramphenicol therapy
Abstract:
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.
Insights
Salmonella typhi infection initially lowers serum iron and zinc. Chloramphenicol therapy, not the disease itself, increases iron levels during fever, while zinc increases are disease-related.
Area of Science:
- Infectious Diseases
- Nutritional Biochemistry
- Pharmacology
Background:
- Salmonella typhi infection, or typhoid fever, causes significant alterations in essential trace metal levels.
- Early stages of infection show depressed serum iron and zinc, with a concurrent rise in serum copper.
- The precise mechanisms and influences of treatment on these trace metal shifts remain incompletely understood.
Purpose of the Study:
- To investigate the impact of Salmonella typhi infection and chloramphenicol therapy on serum iron, zinc, and copper concentrations.
- To differentiate between disease-related and treatment-related changes in trace metal levels during typhoid fever.
- To highlight the clinical significance of monitoring trace metals in infectious diseases and during antibiotic treatment.
Main Methods:
- Experimental infection of volunteers with Salmonella typhi and monitoring of serum trace metal levels.
- Clinical observation of typhoid fever patients undergoing different antibiotic treatments (chloramphenicol, cefazolin, gentamicin).
- Infection of rhesus monkeys with Salmonella typhimurium to study disease-related effects in a non-human model.
Main Results:
- Serum iron and zinc significantly decreased before overt illness in experimentally infected volunteers.
- Chloramphenicol therapy led to a significant increase in serum iron during the febrile phase.
- Serum zinc concentrations increased as a phenomenon related to the disease process itself, independent of chloramphenicol.
- Serum copper levels showed a concomitant rise with the depression of iron and zinc.
Conclusions:
- The increase in serum iron during typhoid fever is primarily attributed to chloramphenicol therapy.
- Elevated serum zinc during the febrile phase is a consequence of the Salmonella typhi infection.
- Trace metal monitoring is crucial for managing infectious diseases and understanding chemotherapy effects.