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[Typhoid fever: relapse due to antimicrobial resistance. Case report]
Wilson Duarte Alecrim1, Adalgisa Câmara de Sá Peixoto Loureiro, Ricardo Silva Moraes
1Fundação Universidade do Amazonas, Manaus, Brasil. walecrim@uol.com.br
Revista Da Sociedade Brasileira De Medicina Tropical
|March 4, 2003
Summary
A typhoid fever patient in the Brazilian Amazon showed resistance to chloramphenicol, the primary treatment. This case highlights the urgent need for monitoring antimicrobial resistance in Salmonella Typhi.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Typhoid fever remains a significant public health concern globally.
- Chloramphenicol has been a cornerstone treatment for typhoid fever in many regions, including the Brazilian Amazon.
- Emergence of antimicrobial resistance poses a threat to effective disease management.
Observation:
- A case of typhoid fever in the Brazilian Amazon presented with clinical and laboratory evidence of resistance to chloramphenicol.
- The patient experienced a relapse of symptoms seven days after completing chloramphenicol treatment.
- This marks the first reported instance of chloramphenicol-resistant typhoid fever in this specific geographic area.
Findings:
- The causative agent, Salmonella Typhi, demonstrated resistance to chloramphenicol.
- The patient was successfully retreated with ciprofloxacin, indicating alternative therapeutic options.
- This finding underscores the evolving resistance patterns of typhoid pathogens.
Implications:
- The emergence of chloramphenicol resistance necessitates a re-evaluation of empirical treatment guidelines for typhoid fever in the Brazilian Amazon.
- Enhanced surveillance for antimicrobial resistance in Salmonella Typhi is crucial for effective public health interventions.
- Development and implementation of rapid diagnostic tools for resistance detection are warranted.