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Changing spectrum of typhoid

A B Durrani1, S M Rab

  • 1Durrani Clinic, Quetta.

JPMA. the Journal of the Pakistan Medical Association
|March 1, 1996
PubMed
Summary
This summary is machine-generated.

This study on typhoid fever found classic symptoms are less common. However, Salmonella typhi remains sensitive to key antibiotics like ofloxacin, ceftriaxone, and ciprofloxacin.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Typhoid fever, caused by Salmonella typhi, presents a significant global health challenge.
  • Understanding the evolving clinical spectrum and antimicrobial susceptibility of typhoid fever is crucial for effective treatment.

Purpose of the Study:

  • To investigate the changing clinical presentation of typhoid fever over a four-year period.
  • To assess the antimicrobial sensitivity patterns of Salmonella typhi strains.

Main Methods:

  • A retrospective analysis of 240 typhoid fever cases admitted over four years.
  • Clinical data review, including symptoms, complications, and laboratory findings.
  • Bone marrow cultures performed on untreated and partially treated patients.

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  • Antimicrobial susceptibility testing of isolated Salmonella typhi strains.

    • Main Results:

    • Classical symptoms like 'Stepladder fever' and 'relative bradycardia' were observed less frequently.
    • Atypical presentations including hepatitis, psychosis, and myopathy were noted in a subset of patients.
    • Bone marrow cultures yielded positive results in all untreated/partially treated cases.
    • All Salmonella typhi isolates demonstrated sensitivity to ofloxacin, ceftriaxone, and ciprofloxacin.

    Conclusions:

    • The clinical spectrum of typhoid fever appears to be shifting, with a decrease in classic signs.
    • Despite changes in presentation, Salmonella typhi remains susceptible to commonly used antibiotics such as ofloxacin, ceftriaxone, and ciprofloxacin.
    • Bone marrow culture remains a reliable diagnostic tool for typhoid fever, especially in inadequately treated patients.