Abstract

To characterize clinical correlates of typhoid fever-associated encephalopathy, we performed a retrospective chart review of patients with Salmonella enterica serotype Typhi bacteremia who were hospitalized at the International Centre for Diarrhoeal Disease Research, Bangladesh, from February of 2009 to June of 2011. Of 207 patients bacteremic with Salmonella Typhi who were ≥ 5 years of age, we identified 43 (21%) patients with encephalopathy. Univariate analysis revealed that patients with encephalopathy more often presented at ages of 10-24 years and had severe dehydration, low oxygen saturation, high respiratory rate, low leukocyte count, low platelet count, and Widal flagellar H agglutinin (TH) titer ≥ 1:640 compared with typhoid patients without encephalopathy. Multivariate analysis using logistic regression showed that age, dehydration, leukocyte count, and Widal TH titer were independently associated with encephalopathy. Our findings suggest that age, severity of disease, and immune responses are associated with encephalopathy during Salmonella Typhi bacteremia, perhaps reflecting the impact of prominent inflammatory responses.

Links

Publisher Full Text

Authors

Leung DT, Bogetz J, Itoh M, Ganapathi L, Pietroni MA, Ryan ET, Chisti MJ

Institution

Division of Infectious Disease, Massachusetts General Hospital, Boston, 02114, USA. dleung@partners.org

Source

The American journal of tropical medicine and hygiene 86:4 2012 Apr pg 698-702

MeSH

Adolescent
Adult
Anti-Bacterial Agents
Bacteremia
Bangladesh
Brain Diseases
Child
Child, Preschool
Diarrhea
Female
Hospitals
Humans
Logistic Models
Male
Retrospective Studies
Salmonella typhi
Serotyping
Typhoid Fever
Young Adult

Pub Type(s)

Journal Article
Research Support, American Recovery and Reinvestment Act
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22492156