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At least 19 recordsLinked to original sources
PubMed1979

Detection of antibodies to Salmonella "O" antigens in typhoid fever by counterimmunoelectrophoresis. II. Assessment in patients with typhoid fever and in a healthy population.

Two different population groups were studied. In one, 50 patients with a confirmed diagnosis of typhoid fever. Serum determinations were made for the detection of antibodies to S. typhi somatic antigen using Widal technique, surface fixation test and counterimmunoelectrophoresis (CIE). In the other group, 350 healthy subjects were studied to determine the minimum diagnostic titer by means of CIE. It was possible to establish that a 1:16 titer was suggestive of typhoid fever when CIE techniques were used. Surface fixation test showed the highest sensitivity levels. CIE with sensitivity levels similar to those found in Widal's reaction exceeds the other test because of its standardization and greater reproducibility.

Adolescent↗
PubMed1989

[The neutrophil receptor apparatus in typhoid fever].

In 157 typhoid fever patients and 36 practically healthy persons the content of neutrophils forming complement-dependent rosettes (NEAC rosette-forming cells), as well as rosettes with sheep red blood cells (NE rosette-forming cells) and with typhoid erythrocyte diagnosticum (NS rosette-forming cells), has been studied. The data obtained in this investigation indicate that antigen-binding neutrophils play an active functional role in the pathogenesis of typhoid fever at its acute stage. The values characterizing the content of N rosette-forming cells may be used as a criterion for the evaluation of the severity of infection, as well as for the prognostication of complications and relapses.

Adolescent↗
PubMedDate not supplied

Selective primary health care: strategies for control of disease in the developing world. XX. Typhoid fever.

The incidence of typhoid fever remains unacceptably high in developing countries. Because Salmonella typhi is disseminated by carriers, there is an urgent need to increase the rate of detection of carriers and to decrease the risk they pose to their communities. In urban areas where sewage disposal is lacking or inadequate, public water supplies are contaminated and typhoid fever is common. The contamination of food by carriers is the second commonest route of infection. Water purification processes lead to a rapid decline in the incidence of the disease; thus, many developing countries hope to develop pure water supplies for all citizens by the end of this century. Until this important public health goal is achieved, the use of vaccine, especially in children, could cause a significant decrease in the incidence of typhoid fever. A new oral attenuated vaccine promises to be effective and safe.

Age Factors↗
PubMedDate not supplied

Surgical complications of typhoid fever: enteric perforation.

Typhoid fever remains a prevalent disease in developing nations as the result of adverse socioeconomic factors. The most frequent complication, and principal cause of mortality, is perforation of the terminal ileum. This report presents our experience with 96 patients surgically treated at Cayetano Heredia University Hospital in Lima, Peru from 1972 to 1986. The clinical characteristics and the diverse surgical procedures utilized in the management of these patients are reviewed.

Humans↗
PubMed1989

General considerations in the management of typhoid fever and dysentery.

Typhoid fever is diagnosed on the basis of isolation of Salmonella typhi from blood, bone marrow, or bile. S. typhi found in stool or urine may reflect chronic asymptomatic carriage. Although antimicrobial therapy may not eliminate carriage, it is effective for the treatment of clinically evident acute disease. Among the drugs currently available, chloramphenicol is the most widely used. Chloramphenicol is effective and inexpensive, but it is associated with a 3% rate of chronic carriage, a high relapse rate, and, in rare cases, aplastic anemia. For these reasons, and because of the emergence of chloramphenicol-resistant strains of S. typhi, alternative drugs need to be considered. Dysentery is characterized by the passage of unformed stools that commonly contain blood and mucus and in which large numbers of leukocytes can be detected on microscopic examination. Invasion of the intestinal epithelium is the distinguishing characteristic, and Shigella sp are the most frequent cause. Although oral rehydration is useful in dehydrated patients, dehydration is not a common problem in acute dysentery, and antimicrobial treatment is indicated for this disease. An antimicrobial agent should be selected on the basis of knowledge of the susceptibility patterns of locally isolated Shigella strains.

Anti-Infective Agents↗
PubMed1976

The management of typhoid fever.

The diagnosis of typhoid fever requires clinical alertness and ready laboratory support, blood cultures being most important. Chloramphenicol remains the standard drug specific for acute typhoid fever while cotrimoxazole is a useful alternative. Both of these are also useful in the treatment of relapses. The importance of supportive treatment cannot be over-emphasized. The treatment of intestinal complication is mainly conservative. Steroid is useful in the toxic delirious state. The management of chronic typhoid carriers is still an unsolved problem. To exclude the chronic carriers from handling food and to give advice on meticulous attention to personal hygiene is still the best way of public health control.

Ampicillin↗
PubMed1988

Haemoglobinuric renal failure and typhoid fever.

Three patients with typhoid fever, initially misdiagnosed, developed intravascular haemolysis, disseminated intravascular coagulation, haemoglobinuria and acute renal failure. 2 of the patients were deficient in erythrocyte glucose-6-phosphate dehydrogenase; Plasmodium falciparum was present in the blood of the third. Among the indigenous population of endemic areas, typhoid fever is the likely diagnosis in any pyrexial illness associated with haemoglobinuric renal failure.

Acute Kidney Injury↗
PubMed1977

Therapy of antimicrobial-resistant typhoid fever.

Antimicrobial-resistant typhoid fever in Saigon was studied by examining in vitro antimicrobial susceptibilities of Salmonella typhi strains and conducting a randomized clinical trial of ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ). Isolates of S. typhi were obtained from blood or stool cultures of 90 patients. Of 87 isolates tested for antimicrobial susceptibility, 65 (75%) were resistant (R) to chloramphenicol, streptomycin, sulfonamide, and tetracycline, and 22 (25%) were susceptible (S). The drug resistance was transferable to Escherichia coli and was found in 11 different Vi-phage types. All isolates were susceptible to ampicillin and to TMP-SMZ. Agar dilution studies of TMP and SMZ showed synergistic inhibition of growth in all 18 S isolates and in 12 of 48 R isolates tested. The clinical trial of ampicillin and TMP-SMZ showed that both drugs were equally effective. Treatment failure with both drugs was more frequent in patients with S isolates than in patients with R isolates. Therefore, in an area where antimicrobial-resistant typhoid fever exists, patients with R isolates should receive either ampicillin or TMP-SMZ, but patients with S isolates should be treated with chloramphenicol.

Ampicillin↗
PubMed1989

Diagnostic usefulness of Vi-indirect fluorescent antibody test(Vi-IFAT) for typhoid fever--a prospective study.

Although the confirmative diagnosis of typhoid fever is by culture of the causative organism, usually from blood, a serological test is still necessary to provide a more rapid method of diagnosis. The indirect fluorescent antibody test, using a Salmonella typhi Vi antigen and a FITC-conjugated rabbit anti-human polyvalent immunoglobulin, was evaluated for the diagnosis of typhoid fever. Serum specimens were collected from patients with febrile diseases on admission. Of the 32 patients with titers of 1:64 or more, 22 were confirmed to have typhoid fever by blood culture and 7 had fever of undetermined origin that was considered to be typhoid fever clinically. Three patients were diagnosed to have salmonellosis other than typhoid fever. Of the 121 patients with titers of 1:32 or less, 105 patients had non-typhoidal febrile disease, 15 patients had fever of undetermined origin, and one patient was confirmed to have typhoid fever by blood culture. When a Vi antibody titer of 1:64 or more was taken as serological evidence for the diagnosis of typhoid fever, the sensitivity and specificity were 95.7% and 97.2%, respectively. The incidence of positive test results following fever onset was 70.0% within 1 week of fever onset, 88.9% from 1 to 2 weeks, and 100% after 2 weeks. In conclusion, the Vi-indirect fluorescent antibody test(Vi-IFAT) can be employed as a useful serologic test in the diagnosis of typhoid fever.

Antigens, Bacterial↗
PubMed1989

Typhoid fever in Hong Kong children.

Experience with typhoid fever in 111 children over a 5-year period was reviewed. There were 66 boys and 45 girls, ranging in age from 1 to 11.5 years. The symptoms of typhoid fever were quite non-specific. Fever was the most common presenting symptom (in 98.3%). Other common presenting features were diarrhoea (25.7%), constipation (22%), vomiting (21.1%), cough (25%), abdominal pain (27.5%), headache (9.2%), epistaxis, meningism and convulsions. Rose spots were detected in 20% of cases, occurring mainly during the first 2 weeks of illness. Significant Widal reactions were present in 84.7% of cases. Blood and stool cultures were positive in 57% and 44% of cases, respectively. Peripheral blood white cell counts were not found to be of great diagnostic value. Chloramphenicol remained the drug of choice in the treatment of typhoid fever. It was more effective than ampicillin or co-trimoxazole. Complications were uncommon, occurring in only two patients. There were two deaths; both were admitted late and in moribund state. Early diagnosis and treatment is vital in typhoid fever and, as the presenting features are non-specific, a high index of suspicion is required.

Ampicillin↗
PubMed1991

Relative sensitivity of blood and bone marrow cultures in typhoid fever.

In a prospective study of typhoid fever in Ahmadu Bello University Hospital, Zaria, the relative diagnostic sensitivities of blood culture and bone marrow culture were studied. The results in 64 patients with proved diagnosis of typhoid fever (either by recovery of S. typhi from stool, blood and/or bone marrow or by a positive Widal agglutination test) are presented. Forty-four per cent and 59% of the patients yielded S. typhi on blood and bone marrow cultures, respectively. In 31 patients who were investigated by both blood and bone marrow cultures, the yields of S. typhi were 35% and 61% respectively. This difference is statistically significant (P less than 0.05). In this study bone marrow culture proved to be the most sensitive diagnostic test for typhoid fever. A simple technique of bone marrow aspiration is described and its use is recommended for large general teaching hospitals.

Blood↗
PubMed1991

Fluoroquinolones in the treatment of typhoid fever and the carrier state.

Typhoid fever remains an important public health problem throughout the world with a higher morbidity and mortality rate in the developing countries. Early establishment of the diagnosis and prompt initiation of treatment with chloramphenicol, ampicillin or trimethoprim-sulfamethoxazole is not necessarily followed by complete resolution of the infection. Between 1% and 6% of patients with typhoid fever become chronic biliary carriers of Salmonella typhi. These carriers are potential factors in the continued transmission of the disease. The increasing emergence worldwide of strains showing multiple resistance to the agents traditionally used in therapy has encouraged investigators to seek alternatives such as third generation cephalosporins and recently the new 4-quinolones, which have greater activity against Salmonella typhi including multi-resistant strains. The fluoroquinolones seem to be the treatment of choice in those regions where resistant strains of Salmonella typhi are prevalent.

4-Quinolones↗
PubMed1991

Oral immunisation against typhoid fever in Indonesia with Ty21a vaccine.

When tested under conditions of moderate transmission of typhoid fever, a liquid formulation of the oral typhoid fever vaccine Ty21a had a protective efficacy of 96% in Egypt, and an enteric coated capsule formulation had an efficacy of 67% in Chile. We compared the two formulations under conditions of intense transmission of typhoid fever in Indonesia in a randomised, double-blind trial. 20,543 subjects (age range 3-44 years) received either three doses of enteric coated capsules containing placebo or live Ty21a, or three doses of lyophilised placebo or live Ty21a reconstituted with phosphate buffer. During 30 months of follow-up, the rate of blood-culture-positive typhoid fever among controls was 810/100,000 per year. Rates of typhoid fever were 379/100,000 per year for subjects who received the liquid formulation of vaccine and 468/100,000 per year for subjects who received enteric coated capsules. The protective efficacies of the liquid and enteric coated formulations were 53% and 42%, respectively. Neither formulation protected against infection with Salmonella paratyphi A. No major side-effects were noted, but the overall incidence of side-effects was greater in the vaccine groups. Under conditions of intense transmission, Ty21a protected against typhoid fever; however, because Ty21a will not protect all individuals, there is a need for additional approaches to prevent the disease.

Administration, Oral↗