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Haemostatic abnormalities in multidrug-resistant enteric fever

P A Koul1, M I Quadri, J I Wani

  • 1Department of Internal Medicine, Institute of Medical Sciences, Soura, Srinagar, Kashmir, India.

Acta Haematologica
|January 1, 1995
PubMed
Summary

Multidrug-resistant enteric fever frequently causes disseminated intravascular coagulation (DIC), a blood clotting disorder. However, DIC typically resolved within eight days with appropriate antibiotic treatment.

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Area of Science:

  • Infectious Diseases
  • Hematology
  • Critical Care Medicine

Background:

  • Enteric fever, particularly multidrug-resistant strains, poses a significant global health challenge.
  • Haemostatic abnormalities, including disseminated intravascular coagulation (DIC), can complicate severe infections.
  • Understanding the coagulopathy associated with enteric fever is crucial for effective patient management.

Purpose of the Study:

  • To investigate the incidence and characteristics of haemostatic abnormalities in patients with multidrug-resistant enteric fever.
  • To assess the role of disseminated intravascular coagulation (DIC) and associated fibrinolysis in these patients.
  • To evaluate the impact of specific antibiotic therapy on the resolution of DIC.

Main Methods:

  • Prospective evaluation of 25 consecutive patients diagnosed with multidrug-resistant enteric fever.

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  • Monitoring for haemostatic abnormalities, including disseminated intravascular coagulation (DIC) and fibrinolysis.
  • Assessment of Protein C activity and clinical bleeding events.

    • Main Results:

    • 84% of patients exhibited evidence of disseminated intravascular coagulation (DIC).
    • 48% of patients showed signs of associated fibrinolysis.
    • Clinical bleeding occurred in 12% of cases, with no correlation to clotting abnormalities.
    • Protein C activity was reduced in 11/15 DIC cases; a block in activation was not confirmed.
    • DIC resolved in most patients within 8 days of initiating antibiotic therapy.

    Conclusions:

    • Multidrug-resistant enteric fever is strongly associated with disseminated intravascular coagulation (DIC).
    • Specific antibiotic therapy is effective in reversing DIC in these patients.
    • Further research is needed to elucidate the precise mechanisms of coagulopathy in enteric fever.