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Typhoid fever in children: a fourteen-year experience
1Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Insights
Typhoid fever in children aged 5-15 years often presents with gastrointestinal symptoms and hepatosplenomegaly. Antibiotic resistance of Salmonella typhi was not a significant issue in this study area up to 1995.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Typhoid fever remains a significant public health concern in many regions.
- Understanding the clinical presentation and complications in pediatric populations is crucial for effective management.
Purpose of the Study:
- To analyze the epidemiological and clinical characteristics of typhoid fever in children.
- To assess the incidence of complications and antibiotic susceptibility of Salmonella typhi isolates.
Main Methods:
- Retrospective review of 71 children diagnosed with typhoid fever between 1982 and 1995.
- Clinical data collection including symptoms, physical signs, complications, and treatment outcomes.
- In vitro antibiotic susceptibility testing of Salmonella typhi isolates.
Main Results:
- Most cases (83%) occurred in children aged 5-15 years, presenting with fever and gastrointestinal symptoms.
- Hepatosplenomegaly and abdominal tenderness were common physical findings.
- Thrombocytopenia (13%) was the most frequent complication; intestinal perforation and rectal bleeding occurred in 3% of cases.
- Salmonella typhi isolates were susceptible to tested antibiotics, including chloramphenicol, though with higher MIC90 values.
Conclusions:
- Age-specific differences in typhoid fever incidence and morbidity were observed in children.
- Appropriate antimicrobial therapies were effective, with no mortality reported.
- Antibiotic resistance of Salmonella typhi was not a problem in the study area up to 1995.
Abstract:
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.
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