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Typhoid and paratyphoid fever: a retrospective study
D A Ndububa1, G E Erhabor, D O Akinola
1Department of Medicine, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Abstract:
Sixty-eight proved cases of typhoid and paratyphoid fever were reviewed in a retrospective study covering 5 years (1986-1990). Patients within the age range of 10 to 39 years constituted 82.3 per cent of cases and there was equal incidence in both sexes. The mean duration of illness before presentation was 9.67 days. The major clinical features were fever (97%), abdominal tenderness (-9.4%), headache and abdominal pain (70.58%) each). Intestinal perforation was the commonest complication (27.9%) with a male preponderance (M:F-3:1). Perforation occurred after the first week of illness in 73.7 per cent of cases. Fourteen out of the nineteen patients who perforated were not on therapy at the time of perforation and they constituted 80 per cent of those cases of mortality in which perforation played a role. Surgical management of perforation gave better results than conservative management (mortality rates of 16.7% and 40% respectively). Salmonella was sensitive to Chloramphenicol in all the cases where the organism was grown. There were 10 recorded deaths (14.9%) of whom 60 per cent (i. e. 6 patients) presented after two weeks of illness.
Insights
This study on typhoid and paratyphoid fever found intestinal perforation a major complication, particularly in males. Early surgical intervention for perforation significantly reduced mortality rates.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Public Health
Background:
- Typhoid and paratyphoid fevers remain significant global health concerns.
- Understanding the epidemiology and clinical presentation is crucial for effective management.
Purpose of the Study:
- To review clinical features, complications, and outcomes of typhoid and paratyphoid fever cases.
- To evaluate the effectiveness of surgical versus conservative management for intestinal perforation.
Main Methods:
- Retrospective study of 68 confirmed cases over a 5-year period (1986-1990).
- Analysis of patient demographics, clinical presentation, complications, treatment, and mortality.
Main Results:
- Fever, headache, and abdominal pain were predominant symptoms.
- Intestinal perforation occurred in 27.9% of cases, with a male predominance.
- Surgical management of perforation had a lower mortality rate (16.7%) compared to conservative management (40%).
- Salmonella isolates were uniformly sensitive to Chloramphenicol.
Conclusions:
- Intestinal perforation is a critical complication of typhoid and paratyphoid fever, necessitating prompt surgical intervention.
- Delayed presentation and lack of therapy at perforation increase mortality risk.
- Chloramphenicol remains an effective antibiotic for Salmonella infections.