Clinical presentation of enteric fever: its changing pattern in Kuwait

Area of Science:

• Infectious Diseases
• Clinical Medicine
• Public Health

Background:

• Enteric fever, encompassing typhoid and paratyphoid fever, presents a significant public health challenge.
• Clinical data from 1985-1989 at a Kuwaiti general hospital reveal insights into disease patterns and outcomes.

Purpose of the Study:

• To analyze the clinical experience and epidemiological trends of enteric fever in Kuwait.
• To identify complications, mortality rates, and emerging challenges like drug resistance.

Main Methods:

• Retrospective review of 100 enteric fever cases (90 typhoid, 10 paratyphoid).
• Analysis of clinical presentations, complications, treatment outcomes, and drug resistance patterns.

Main Results:

• A 2% mortality rate was observed, with complications including bowel perforation, hemorrhage, septic shock, and abortion.
• Neurological/psychiatric manifestations occurred in 15% of cases. Most infections (78%) were imported, though local acquisition decreased over time.
• Five drug-resistant Salmonella typhi isolates were identified between 1988-1989, indicating a concerning trend.

Conclusions:

• Enteric fever diagnosis can be challenging, particularly in children, necessitating improved diagnostic methods.
• The emergence of drug-resistant strains highlights the need for updated treatment strategies and antibiotic surveillance.
• Continued vigilance and research are essential to combat enteric fever effectively, especially with evolving resistance patterns.