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Changing characteristics of typhoid fever in Taiwan.
J Microbiol Immunol Infect. 2004 Apr; 37(2):109-14.JM

Abstract

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.

Authors+Show Affiliations

Department of Emergency Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan 100, ROC.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15181493

Citation

Su, Chan-Ping, et al. "Changing Characteristics of Typhoid Fever in Taiwan." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 37, no. 2, 2004, pp. 109-14.
Su CP, Chen YC, Chang SC. Changing characteristics of typhoid fever in Taiwan. J Microbiol Immunol Infect. 2004;37(2):109-14.
Su, C. P., Chen, Y. C., & Chang, S. C. (2004). Changing characteristics of typhoid fever in Taiwan. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 37(2), 109-14.
Su CP, Chen YC, Chang SC. Changing Characteristics of Typhoid Fever in Taiwan. J Microbiol Immunol Infect. 2004;37(2):109-14. PubMed PMID: 15181493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changing characteristics of typhoid fever in Taiwan. AU - Su,Chan-Ping, AU - Chen,Yee-Chun, AU - Chang,Shan-Chwen, PY - 2004/6/8/pubmed PY - 2004/12/16/medline PY - 2004/6/8/entrez SP - 109 EP - 14 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 37 IS - 2 N2 - 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. SN - 1684-1182 UR - https://www.unboundmedicine.com/medline/citation/15181493/Changing_characteristics_of_typhoid_fever_in_Taiwan_ L2 - http://www.diseaseinfosearch.org/result/7276 DB - PRIME DP - Unbound Medicine ER -