Fatal complications of acute enteric fevers

Eighty eight patients presenting with fatal typhoid complications were studied in Abbassia and Embaba fever hospitals during a 4 years period (1987-1991). Criterion of inclusion in the study was either positive blood culture in 70 (80%) cases or postmortem gross appearance of typhoid fever in 18 (20%) cases. Positive blood culture cases included 54 (77%) S. typhi and 16 (23%) S. paratyphi A. Seven (10%) cases were resistant in vitro to chloramphenicol. Postmortem examination performed in 18 (20%) cases revealed typical typhoid ulcers in ileum, jejunum and large intestine. The main clinical picture of 31 toxic, 22 encephalitic or meningeal irritating, 15 gastroenteritic, 9 pneumonic, 8 perforated and 3 haemorrhagic enteric fever cases were discussed. The tetrad of fever, toxic look, bronchitic chest, tumid tympanitic abdomen and splenomegaly was a good sign for suggestion of typhoid diagnosis.