Multi-drug resistant typhoid fever with diarrhea

Area of Science:

• Pediatric Infectious Diseases
• Gastroenterology
• Microbiology

Background:

• Multi-drug resistant *Salmonella Typhi* (S. typhi) poses a significant global health challenge, particularly in pediatric populations.
• Typhoid fever, a systemic infection caused by *S. typhi*, often presents with prolonged fever and diarrhea, complicating diagnosis and treatment.

Purpose of the Study:

• To characterize the stool properties in children with multi-drug resistant typhoid fever.
• To evaluate the clinical course and treatment outcomes using furazolidone or ciprofloxacin.

Main Methods:

• A hospital-based study involving 21 male children diagnosed with multi-drug resistant *S. typhi* via blood and stool cultures.
• Analysis of stool characteristics, including volume, leukocyte and red blood cell presence, and electrolyte content.
• Treatment with either furazolidone or ciprofloxacin, with subsequent clinical evaluation until recovery.

Main Results:

• Patients exhibited prolonged fever (mean 19.1 days) and diarrhea (mean 15.8 days).
• Stools were predominantly watery (81%) with moderate leukocyte presence (66.7%) and occasional blood (19% occult, 52.4% RBCs).
• Fecal electrolytes showed patterns distinct from cholera, resembling shigellosis; most children had no dehydration and normal serum electrolytes, recovering with antibiotic therapy.

Conclusions:

• The stool characteristics in multi-drug resistant typhoid fever are watery with minimal blood and electrolyte profiles similar to shigellosis.
• Furazolidone and ciprofloxacin demonstrated effectiveness in treating pediatric cases of multi-drug resistant typhoid fever.