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PubMed1998

[Septic shock with coma revealing typhoid fever].

BACKGROUND: Typhoid fever may be difficult to distinguish from malaria. Septic shock, encephalopathy and leukopenia are common features of both diseases. CASE REPORT: A 20-year-old South Korean woman was admitted to the intensive care unit with coma and shock. Vomiting and abdominal pain were followed by headache, prostration, fever and diarrhea. Leukocytopenia, lymphocytopenia, thrombocytopenia, rhabdomyolysis and hepatitis were present. Clotting tests were normal. The thick peripheral blood film was negative. Salmonella typhi was isolated from 6 blood cultures. Treatment associated ceftriaxone 4 g per day for 5 days, colloid and crystalloid fluids and dopamine. The patient was discharged 2 weeks later. DISCUSSION: Typhoid fever should be considered as a diagnosis in patients with sepsis who come from endemic zones. Abdominal symptoms, prolonged fever, coma and delayed headache are particularly contributive signs. Specific treatment should be instituted.

Adult↗
PubMed1982

Immunological studies in typhoid fever. II. Cell-mediated immune responses and lymphocyte subpopulations in patients with typhoid fever.

The development of the cell-mediated immune response (CMIR) to antigens prepared from Salmonella typhi was investigated in patients suffering from typhoid fever and in normal healthy subjects. The leucocyte migration inhibition test, blast transformation of lymphocytes and active rosette-forming cells were used for detecting CMIR. Peripheral blood lymphocytes were analysed for the numbers and proportions of B lymphocytes, T lymphocytes and their subpopulations with receptors for IgM (T micro) or IgG (T gamma) and cells with Fc receptors for IgG. These parameters were correlated with the duration and the severity of illness. The uncomplicated cases of typhoid fever were found to have an intact CMIR as compared to the complicated cases. The ratio of T lymphocyte subpopulations was grossly imbalanced in typhoid patients, the numbers of T lymphocytes and their subpopulations were further altered in he complicated cases as compared to uncomplicated cases. The present study demonstrates a depressed state of CMIR in complicated patients with typhoid fever. CMIR may thus emerge as the cardinal point for recovery in typhoid fever rather than the specific antibodies. The study further demonstrates that imbalance within the subsets of T lymphocytes may be responsible for the depressed state of CMIR in complicated cases of typhoid fever.

Adolescent↗
PubMed1981

Immunological studies in typhoid fever. I. Immunoglobulins, C3, antibodies, rheumatoid factor and circulating immune complexes in patients with typhoid fever.

The development of O, H and Vi antibodies to Salmonella typhi antigens, immunoglobulins and C3 levels, and the presence of rheumatoid factor and circulating immune complexes were determined in the sera of patients with typhoid fever and appropriate age and sex-matched controls. IgM, and both O and H antibodies were raised in typhoid patients. Rheumatoid factor, a possible indicator of persistent circulating immune complexes, was also present in these patients. Immune complexes were more often present in patients with typhoid fever than in controls, their presence was much more marked in complicated cases of typhoid fever. A high ratio of alpha 1-antitrypsin to C3 was found in these patients suggesting complement consumption.

Adolescent↗
PubMed1996

Acute viral hepatitis A: a cause of jaundice in typhoid fever.

A typhoid patient presenting with fever and jaundice is reported. Investigations revealed that the patient had both typhoid fever and acute viral hepatitis A. Jaundice is a rare clinical presentation in typhoid fever, therefore hepatitis A should be considered in typhoid fever and jaundice because both enterically transmitted disease may simultaneously occur.

Acute Disease↗
PubMed2006

Prospective evaluation of a rapid diagnostic test Typhidot for typhoid fever.

BACKGROUND & OBJECTIVE: Typhoid fever still continues to be a major public health problem around the world. A simple, reliable and affordable rapid diagnostic test has been a long felt need of the clinicians. We therefore prospectively evaluated the sensitivity and specificity of Typhidot test. METHODS: The study was carried out between January 2002 and December 2003, on a total of 563 samples from patients clinically suspected to have typhoid fever; blood culture as well as serum for Typhidot test were received. RESULTS: Of the 563 samples, Typhidot test and blood culture were positive in 36 patients, both the tests were negative for 503 patients. Typhidot test was positive for 9 patients with S. Paratyphi A infection. The sensitivity and specificity of the test using blood culture as gold standard were 92.3 and 98.8 per cent respectively for the typhoid fever. INTERPRETATION & CONCLUSION: Typhidot test is rapid, easy to perform and reliable test for diagnosing typhoid fever, useful for small less equipped laboratories as well as for those with better facilities.

Antibodies, Bacterial↗
PubMed2004

Changing characteristics of typhoid fever in Taiwan.

Typhoid fever, a systemic disease caused by Salmonella typhi, is classically characterized by fever and abdominal symptoms. Although now considered uncommon, it seems to have re-emerged in Taiwan in recent years. We conducted a retrospective study of the clinical characteristics and microbiologic findings in 24 confirmed cases of typhoid fever treated over a 7-year period at a medical center in northern Taiwan. There were 11 males and 13 females, including 15 adults (over 18 years in age) and 9 children. Their mean age was 24.7 years (range, 9 months to 58 years). Twelve patients had recently returned from abroad, mostly from Southeast Asia. The most common complaints were fever (24/24), diarrhea (18/24), abdominal pain (10/24), and cough (10/24). The average duration of fever before diagnosis was 14.1 days, with a maximum of 30 days. Relative bradycardia was noted in 6 patients. Leukopenia was noted in 2 patients. S. typhi was isolated from blood culture in 20 cases, from stool culture in 3 cases, and from bone marrow culture in 1 case. Widal test was only positive initially in 7/18 cases. Fever of unknown origin was the most common initial diagnosis. Typhoid or enteric fever was impressed initially in only 2 cases. Almost all isolates of S. typhi were susceptible to antibiotics currently used for typhoid fever, with only 1 isolate resistant to chloramphenicol. All patients survived after antibiotic treatment. Only 1 patient developed recurrence after a 10-day course of ceftriaxone. In conclusion, the diagnosis of typhoid fever is often challenging due to non-specific symptoms and lack of an immediate confirmatory test. It is important to include this disease in the differential diagnosis of febrile patients with abdominal symptoms.

Abdominal Pain↗
PubMed1952

Changing epidemiologic aspects of typhoid fever in California.

Typhoid fever in California is no longer a major public health problem. The previously high incidence of water- and milk-borne infections has been greatly reduced. Human carriers now are the source of most infections. Chloramphenicol has proven to be a valuable aid in the therapy of the acutely ill patient, but it has not as yet solved the therapeutic or public health problems of typhoid fever. It continues to be vital for the protection of the public that every suspected case of typhoid fever be definitely established by appropriate public health laboratory procedures, that thorough investigation be carried out to determine the source of infection, and that careful follow-up examinations be done so that if a carrier state develops, proper measures can be taken.

Biometry↗
PubMed1998

[Evaluation of the Widal test for diagnosing typhoid fever in Lebanon].

Typhoid fever is a major public health problem in developing countries. In Lebanon, where the sanitary infrastructure was severely damaged during the civil war, the high prevalence of typhoid fever creates a pressing need for a rapid and reliable diagnostic tool. To evaluate the diagnostic usefulness of the Widal test, patients with a positive blood culture for Salmonella typhi (n = 78) were compared to controls with fever due to another infection (n = 65) and with blood donors (n = 96). Discrimination between the patient group and the two control groups was best when an agglutinin O titer of 1/160 or more was used. With this cutoff, sensitivity was 67.9%; specificity was 93.8% versus the febrile controls and 100% versus the blood donors. These results suggest that despite its well-known limitations the Widal test remains a valuable tool for typhoid fever control in many developing countries.

Antigens, Bacterial↗
PubMed1994

Vaccination against typhoid fever: present status.

Typhoid fever remains an underestimated important health problem in many developing countries, causing more than 600,000 deaths annually in the world. Because of the reactogenicity of the parenteral, killed whole-cell vaccine, research has been oriented towards vaccination orally using live organisms and purified antigen. Live vaccine Ty21a, given by the oral route, has been extensively tested in several studies in developing countries. Its liquid formulation was the most effective, providing more than 60% protection after 7 years of follow-up. A Vi polysaccharide vaccine has been elaborated and provided more than 65% protection; after 3 years of follow-up the Vi antibody level was still at a high level. These two vaccines are therefore candidates for use in public health control programmes. Before such use, however, they need further evaluation for safety and protective efficacy when administered to the EPI-targeted age groups. The question of whether typhoid fever vaccines interfere with the response to simultaneously administered measles vaccine must also be studied. New live vaccines, given by the oral route in one dose, have been constructed through genetic engineering. The first results are promising, but they must be improved before use in a large-scale study. These strains could be used as live vector to deliver foreign antigens to the intestinal mucosa.

Administration, Oral↗
PubMed2002

[Typhoid fever and pregnancy].

Typhoid fever is rare in Europe, but well-recognized endemic disease in tropical zones. We report our findings in a series of 25 cases of typhoid fever during pregnancy observed in French Guiana and reviewed the literature on clinical signs, diagnosis and treatment. Salmonellea typhi causes septicemia of digestive origin that can cross the placenta resulting in chorioamniotitis. Maternal-fetal infection with S. typhi can lead to miscarriage, fetal death, neonatal infection, as well as diverse maternal complications. In order to avoid maternal complications and possible fetal transmission, treatment with ceftriaxone should be initiated as early as possible

Abortion, Spontaneous↗
PubMed1983

ELISA determination of IgM anti-LPS in the early phase of typhoid fever.

Sera from typhoid fever patients in the early stage of the disease were tested for the presence of IgM antibodies to LPS of S. typhi by an ELISA method. IgM anti-LPS were present in all 10 typhoid patients, while they were undetectable in sera from both normal and febrile controls. Determination of IgM anti-LPS can be a diagnostic aid in the early phase of typhoid fever.

Adolescent↗
PubMed1985

Typhoid fever complicating pregnancy.

Typhoid fever in pregnancy may result in infection of the fetus, with consequent abortion. Currently, it is a rare complication of pregnancy in the industrially developed countries. This report documents a case of maternal typhoid fever with septic abortion, in which trans-placental infection of the fetus caused its demise.

Abortion, Septic↗