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Comparative study between paratyphoid A and typhoid fever cases.

M F Abdel Wahab1, A N Haseeb, H S Hamdy

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This study compared paratyphoid A fever and typhoid fever in Egypt. Paratyphoid A fever showed fewer anorexia and toxic signs, with blood culture being key for diagnosis.

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Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Epidemiology

Background:

  • Paratyphoid A fever and typhoid fever are significant febrile illnesses caused by Salmonella species.
  • Distinguishing between paratyphoid A fever and typhoid fever clinically can be challenging.
  • Understanding comparative clinical and diagnostic features is crucial for effective management.

Purpose of the Study:

  • To compare acute paratyphoid A fever and acute typhoid fever in Egypt.
  • To evaluate clinical, diagnostic, therapeutic, and prognostic differences.
  • To identify key diagnostic aids for paratyphoid A fever.

Main Methods:

  • A comparative study involving 28 paratyphoid A fever cases and 42 typhoid fever controls.
  • Data collection included medical history, clinical examination, blood cultures, Widal test, and white blood cell counts.
  • Urine and stool cultures were performed post-therapy.

Main Results:

  • Paratyphoid A fever cases showed significantly less anorexia, toxic appearance, and coated tongue compared to typhoid fever.
  • Key clinical signs suggestive of paratyphoid A fever included toxic look, bronchitic chest, splenomegaly, and tympanitis.
  • Blood culture confirmed diagnosis in paratyphoid A fever, with multiple cultures increasing yield; Widal test sensitivity was lower in paratyphoid A fever.
  • Eosinopenia was a consistent finding in paratyphoid A fever, serving as a diagnostic and prognostic aid.

Conclusions:

  • Blood culture is the cornerstone for diagnosing paratyphoid A fever.
  • Specific clinical signs can aid in bedside diagnosis of paratyphoid A fever.
  • While clinical presentations differ slightly, treatment response and complications are similar between paratyphoid A and typhoid fevers.