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Plasma cortisol levels in enteric fever.

S N Khosla, I J Kalra, A Sharma

    The Journal of the Association of Physicians of India
    |October 1, 1989
    PubMed
    Summary

    Patients with severe typhoid fever show lower plasma cortisol levels, while mild cases have elevated levels. Cortisol returns to normal after fever subsides, suggesting short-term steroid supplementation for severe illness.

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    Area of Science:

    • Endocrinology
    • Infectious Diseases
    • Clinical Medicine

    Background:

    • Enteric fever, particularly typhoid, is a significant global health concern.
    • Plasma cortisol levels can be affected by severe illness and physiological stress.
    • Understanding endocrine responses in typhoid fever is crucial for effective management.

    Purpose of the Study:

    • To investigate plasma cortisol levels in patients with culture-positive enteric fever.
    • To compare cortisol levels between severe and mild/moderate typhoid cases.
    • To assess the correlation between cortisol levels and disease severity or complications.

    Main Methods:

    • Plasma cortisol levels were measured in 22 culture-positive enteric fever patients.
    • A control group of 22 patients with non-enteric fever was included.
    • Cortisol levels were assessed on admission and during defervescence.

    Main Results:

    • Severe typhoid cases with toxaemia/complications exhibited lower mean plasma cortisol on admission and defervescence.
    • Mild to moderate typhoid cases showed elevated plasma cortisol levels.
    • Cortisol levels normalized approximately one week after fever resolution in severe cases.

    Conclusions:

    • Severe enteric fever with toxaemia/complications is associated with lower plasma cortisol.
    • Short-term corticosteroid supplementation may be considered for severe typhoid cases without contraindications.
    • Steroid therapy likely needs to be limited to one week post-fever subsidence due to cortisol level normalization.

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