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Enteric fever: diagnostic value of clinical features
A Neopane1, M Poudel, B Pradhan
1Department of Medicine, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal. arpana.neopane@gmail.com
Kathmandu University Medical Journal (KUMJ)
|July 8, 2008
Summary
Clinical symptoms and signs can aid in diagnosing enteric fever, especially when combined into a proposed criterion. This diagnostic tool is valuable in resource-limited settings for identifying enteric fever.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Diagnostic Accuracy
Background:
- Enteric fever remains a significant public health concern, particularly in developing countries.
- Accurate and timely diagnosis is crucial for effective treatment and control of enteric fever.
- Clinical assessment often precedes laboratory confirmation, highlighting the need for reliable diagnostic indicators.
Purpose of the Study:
- To evaluate the diagnostic value of clinical symptoms and signs in enteric fever.
- To propose a clinical diagnostic criterion for enteric fever.
Main Methods:
- A prospective observational study was conducted.
- Febrile patients with a clinical diagnosis of enteric fever were enrolled.
- Diagnosis was confirmed using blood or bone marrow cultures, and the accuracy of clinical signs and symptoms was assessed.
Main Results:
- Blood/bone marrow cultures confirmed enteric fever in 64% of clinically diagnosed cases.
- The diagnostic accuracy of individual symptoms and signs varied, with headache (75.5%), relative bradycardia (66%), and fever (64%) showing higher accuracy.
- A proposed diagnostic criterion, combining major and minor clinical features, achieved an overall accuracy of 66%.
Conclusions:
- Clinical diagnosis of enteric fever is highly beneficial, particularly in resource-limited settings.
- While individual clinical features have moderate diagnostic accuracy, a composite diagnostic criterion can improve diagnostic precision.
- The proposed criterion, incorporating both major and minor signs and symptoms, represents a valuable tool for diagnosing enteric fever.
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