Ngwu B A, Agbo J A
Department of Medical Microbiology, Ebonyi State University Teaching Hospital, Nigeria.
Niger J Med. 2003 Oct-Dec;12(4):187-92.
Recently there has been an increase in the clinically diagnosed typhoid fever in various parts of Nigeria with subsequent increase in public fear of possible epidemics of the disease. In this study the accuracy of clinically diagnosed typhoid fever were investigated.
Blood and stool specimens from 260 patients clinically diagnosed typhoid fever were investigated using Widal test and bacteriological culture methods respectively.
One hundred and thirty-four (51.5%) of the cases investigated were positive and that there was a significant difference (P < 0.05) between the clinically diagnosed and bacteriologically confirmed typhoid fever cases. Causative organisms were Salmonella typhi 46 (34.3%); S paratyphi B 34 (25.4%); S paratyphi A 24 (17.9%); S paratyphi C 20 (14.9%); other Salmonella spp 10 (7.5%). Young adults and males were predominantely affected.
Most of the clinically diagnosed typhoid cases were misdiagnosis and the hue and cry by the general public on the epidemic of typhoid fever could not be justified. It is recommended that careful detailed history taking, meticulous clinical examination and prompt bacteriological culturing of specimens from suspected typhoid cases will improve the accuracy of clinically diagnosed typhoid fever.
最近，尼日利亚各地临床诊断的伤寒热有所增加，公众对该病可能流行的恐惧也随之增加。在本研究中，对临床诊断伤寒热的准确性进行了调查。
分别采用肥达试验和细菌培养方法，对260例临床诊断为伤寒热的患者的血液和粪便标本进行调查。
134例（51.5%）受调查病例呈阳性，临床诊断的伤寒热病例与细菌学确诊的病例之间存在显著差异（P<0.05）。致病病原体为伤寒沙门菌46例（34.3%）；副伤寒乙沙门菌34例（25.4%）；副伤寒甲沙门菌24例（17.9%）；副伤寒丙沙门菌20例（14.9%）；其他沙门菌属10例（7.5%）。青壮年和男性受影响居多。
大多数临床诊断的伤寒病例为误诊，公众对伤寒热流行的大惊小怪是没有道理的。建议仔细详细询问病史、进行细致的临床检查并对疑似伤寒病例的标本及时进行细菌培养，这将提高临床诊断伤寒热的准确性。
