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[Typhoid fever in children under 2 years of age]
Insights
Typhoid fever in young children presents with severe symptoms like fever, vomiting, and dehydration. Early diagnosis and adequate antibiotic treatment are crucial to prevent complications and mortality in pediatric typhoid cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Context:
- Typhoid fever is a significant global health concern, particularly in resource-limited settings.
- Pediatric populations are vulnerable to severe presentations and complications of typhoid fever.
Purpose:
- To describe the clinical characteristics, diagnostic findings, complications, and outcomes of typhoid fever in children under 12 years.
- To highlight the challenges in diagnosing and managing typhoid fever in infants and young children.
Summary:
- A study of 130 children with typhoid fever, including nine under two years old, revealed frequent symptoms such as high fever, vomiting, diarrhea, malnutrition, and dehydration.
- Blood cultures confirmed Salmonella typhi in all cases. Complications included hepatitis, meningitis, bronchopneumonia, and bleeding disorders. Neutrophilia and anemia were common laboratory findings.
- Two deaths occurred, attributed to delayed diagnosis and inadequate antibiotic therapy, underscoring the need for prompt and effective management.
Impact:
- Findings emphasize the critical need for early recognition and aggressive treatment of typhoid fever in young children to reduce morbidity and mortality.
- This study contributes to understanding the specific challenges and clinical spectrum of pediatric typhoid fever, informing public health strategies and clinical guidelines.
Abstract:
Out of 130 children under 12 years of age with a diagnosis of typhoid fever, nine were under two years of age; the youngest was five months old. Six patients were males and the most frequent findings were: high fever, poor physical condition, vomiting, diarrhea, malnutrition, dehydration, meteorism, liver and spleen enlargement, cough, bleeding disorders and central nervous system abnormalities which were suggestive of sepsis. The clinical diagnosis was confirmed in all patients through the isolation of Salmonella typhi in blood cultures. The Widal reaction showed higher than 1/160 "O" and "H" agglutinin titers in five out of six patients in which it was performed. Neutrophilia was observed in all cases, with a shift to the left in five of them. Anemia was present in all of them. The following complications were found: hepatitis (1 case), hepatitis and meningitis (1 case), bronchopneumonia (1 case), and bleeding abnormalities (4 cases). Two of the patients died; the deaths were attributed to late diagnosis and insufficient antibiotic treatment.