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Clinical and Laboratory Profile of Enteric Fever in Children From a Tertiary Care Centre in Odisha, Eastern India
Jyoti Ranjan Behera1, Amit R Rup2, Arun K Dash2
1Pediatrics, Kalinga Institute of Industrial Technology, Bhubaneswar, IND.
Insights
Enteric fever significantly impacts children in developing nations, often presenting with diverse symptoms. Early diagnosis and appropriate antibiotic use are crucial for effective treatment and prevention through improved public health measures.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Clinical Microbiology
Background:
- Enteric fever poses a significant health challenge in developing countries, frequently leading to diagnostic difficulties and severe complications.
- The varied clinical manifestations of enteric fever complicate early and accurate diagnosis in pediatric populations.
Purpose of the Study:
- To investigate the socio-demographic factors, clinical presentations, and complications of hospitalized enteric fever patients.
- To analyze the antibiotic sensitivity patterns, treatment strategies, and patient outcomes in pediatric enteric fever cases.
- To identify key indicators for early diagnosis and effective management of enteric fever in a tertiary care setting.
Main Methods:
- Retrospective analysis of medical records for pediatric patients (1-14 years) diagnosed with enteric fever.
- Data collection spanned three years (January 2017-December 2019) at a tertiary care center in Odisha.
- Evaluation included clinical data, laboratory results (blood culture, CRP), antibiotic sensitivity, and treatment outcomes.
Main Results:
- 112 pediatric patients were analyzed; 75% were aged 6-14 years, with a male predominance (1.66:1).
- Fever (98.21%) was the most common symptom, followed by vomiting and diarrhea. Eosinopenia and elevated CRP were frequent findings.
- All nalidixic acid-resistant Salmonella Typhi (NARST) isolates showed sensitivity to third-generation cephalosporins. Complications occurred in 21.42% of cases.
Conclusions:
- Enteric fever remains a critical threat to children, necessitating prompt clinical diagnosis and judicious antibiotic selection based on sensitivity testing.
- Public health interventions focusing on improved hygiene, vaccination, and community awareness are essential for enteric fever prevention.
- Effective management requires a multi-faceted approach combining clinical vigilance, appropriate antimicrobial therapy, and preventive strategies.
Background:
Enteric fever is a major health problem in developing countries. Varied clinical presentation leads to diagnostic dilemmas resulting in fatal complications.
Objective:
To determine the socio-demographic, clinical manifestations, complications, antibiotic sensitivity pattern, treatment, and outcome in hospitalized enteric fever patients.
Methods:
A retrospective case record analysis of hospitalized patients in the age group one to 14 years with a discharge diagnosis of enteric fever was done in a tertiary care centre of Odisha over a period of three years (January 2017 to December 2019).
Results:
Of 112 patients, 75% of children belonged to the six to 14 years age group with a mean age of 7.6 +/- 3.6 years and a male to female ratio of 1.66:1. The peak of cases was seen during the month of January to June with 94% of cases occurring in low and middle socioeconomic status. The commonest presentation was fever in 98.21%; other features were vomiting (39.29%), pain in abdomen (21.43%), diarrhoea (26.79%), and anorexia (14.29%). Eosinopenia was found in 58.93%, transaminitis in 30.36%, and raised CRP in 73.21%. In 30 children blood culture was positive with sensitivity to third-generation cephalosporin. All isolates were nalidixic acid-resistant Salmonella Typhi (NARST). Complications were seen in 21.42%. All recovered and two left against medical advice.
Conclusion:
Enteric fever is a major threat in the paediatric age group. Early clinical diagnosis with rational use of antibiotics according to sensitivity pattern is important. Improved hygiene, vaccination, and awareness among people is necessary for prevention.
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