Current clinical patterns of typhoid fever: a prospective study

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Medicine

Background:

• Typhoid fever remains a significant public health concern, particularly in endemic regions.
• Understanding the epidemiology and clinical presentation of typhoid fever is crucial for effective management.
• Previous studies from India have reported varying frequencies of clinical manifestations and complications.

Purpose of the Study:

• To prospectively analyze the clinical features and outcomes of typhoid fever in adult patients.
• To identify the predominant Salmonella species causing typhoid fever in the study population.
• To investigate potential factors influencing the presentation and complications of typhoid fever.

Main Methods:

• Prospective study of 125 consecutive adult patients diagnosed with typhoid fever via positive cultures.
• Identification of Salmonella typhi and Salmonella paratyphi A & B.
• Clinical data collection including fever patterns, presence of rose spots, and complications.

Main Results:

• Salmonella typhi was the predominant pathogen (89.6%), followed by S. paratyphi A & B (10.4%).
• Insidious onset was common; classical step-ladder fever (12%) and rose spots (9.6%) were infrequent.
• Gut perforation was more common, while typhoid toxaemia and peripheral circulatory failure were less frequent than reported in other Indian series.

Conclusions:

• The study highlights a shift in clinical presentation of typhoid fever, potentially influenced by corticosteroid use.
• Gut perforation emerged as a major complication and cause of mortality.
• Further research is warranted to confirm the impact of corticosteroids on typhoid fever's clinical course.