Nakachi Shogo, Nakamura Tetsu, Agha Noor, Daud Sayed, Mohd Sayed, Hadi F, Sajid Azam, Rahman A, Mohd Din, Rahman Zia, Zia Naqibullah
Peshawar-Kai (Japan) Medical Services, Peshawar, Pakistan.
Southeast Asian J Trop Med Public Health. 2003;34 Suppl 2:153-7.
Typhoid fever is endemic in Pakistan. Most patients are children. As the symptoms and signs are often unspecific, it is difficult to diagnose typhoid fever without blood culture. We retrospectively reviewed 51 cases of typhoid fever who were all admitted from 1 June through 31 August 2002. Sixteen cases were positive by blood culture and confirmed as typhoid fever. All cases had Salmonella typhi. Although 16 cases were culture-negative, they were clinically diagnosed as typhoid fever. The remaining 19 cases were clinically diagnosed without blood culture. The clinical features of the culture-confirmed cases were more severe than the culture-negative cases. Mesenteric lymphadenopathy was very frequently detected with ultrasonography, in both culture-confirmed and culture-negative cases. The rates of detecting mesenteric lymphadenopathy were 69% and 63%, respectively. Meanwhile, the rate in non-typhoid fever patients was 5.5%. It was considered that detecting mesenteric lymphadenopathy with ultrasonography was very useful in the diagosis of typhoid fever in endemic areas.
伤寒热在巴基斯坦呈地方性流行。大多数患者为儿童。由于症状和体征往往不具有特异性，因此在没有血培养的情况下很难诊断伤寒热。我们回顾性分析了2002年6月1日至8月31日期间收治的51例伤寒热患者。其中16例血培养呈阳性，确诊为伤寒热。所有病例均感染伤寒杆菌。尽管有16例培养结果为阴性，但临床诊断为伤寒热。其余19例未经血培养即被临床诊断。培养确诊病例的临床特征比培养阴性病例更为严重。在培养确诊和培养阴性的病例中，超声检查均经常发现肠系膜淋巴结肿大。肠系膜淋巴结肿大的检出率分别为69%和63%。同时，非伤寒热患者的检出率为5.5%。据认为，超声检查发现肠系膜淋巴结肿大对地方性流行地区伤寒热的诊断非常有用。
