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Complications of bacteriologically confirmed typhoid fever in children
1Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kuching. asmalik@fhs.unimas.my
Insights
Typhoid fever complications occurred in one-third of children, with hepatitis being common. Splenomegaly, thrombocytopenia, and leukopenia increased complication risk in pediatric typhoid fever patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Typhoid fever remains a significant public health concern, particularly in children.
- Understanding the spectrum and risk factors for typhoid fever complications is crucial for effective management.
Purpose of the Study:
- To determine the incidence, identify markers, and characterize the nature of complications in pediatric typhoid fever.
- To investigate factors associated with the development of complications in children with culture-confirmed Salmonella typhi infections.
Main Methods:
- A prospective, cross-sectional study was conducted over nearly 5 years.
- 102 children with blood culture-positive Salmonella typhi were analyzed.
- Clinical data, laboratory markers, and patient characteristics were collected.
Main Results:
- One-third of children experienced complications, including hepatitis, bone marrow suppression, and SIADH.
- Excluding hepatitis, the complication rate was 11%.
- Splenomegaly, thrombocytopenia, and leukopenia were associated with a higher likelihood of complications.
Conclusions:
- Typhoid fever can lead to a diverse range of serious complications in children.
- Specific hematological findings like splenomegaly and cytopenias may predict complication risk.
- Early recognition and management of these complications are vital in pediatric typhoid fever cases.
Abstract:
To find the incidence, markers and nature of complications of typhoid fever, we studied 102 children with cultures positive for Salmonella typhi in a cross-sectional study, prospectively, over a period of almost 5 years. All isolates were sensitive to commonly used antibiotics. One third of these children developed complications which included: anicteric hepatitis, bone marrow suppression, paralytic ileus, myocarditis, psychosis, cholecystitis, osteomyelitis, peritonitis, pneumonia, haemolysis, and syndrome of inappropriate release of antidiuretic hormone (SIADH). Twelve children developed multiple complications. If hepatitis is excluded from the complications, the rate of complications in bacteriologically confirmed cases of typhoid fever drops to 11 per cent. These complications were not related to: the age or sex of patients, duration of illness before admission, use of antibiotics before admission, nutritional status, level of 'O' or 'H' titre, presence of IgM or IgG antibodies, or treatment with chloramphenicol or ampicillin. Children with splenomegaly, thrombocytopenia or leukopenia were more likely to develop complications.