Infectious diseases Unit, Level 6 Windsor building, Leicester Royal Infirmary, Leicester LE15WW, UK.
J Infect. 2010 Feb;60(2):91-8. doi: 10.1016/j.jinf.2009.11.009. Epub 2009 Dec 3.
Enteric fever is an increasingly common diagnosis in returning travellers in the UK.
We performed a retrospective descriptive study of culture-confirmed cases of enteric fever admitted to University Hospitals Leicester, UK between January 1999 and April 2009.
100 cases of enteric fever were identified in adults (n = 76) and children (n = 24). The median age of adult subjects was 38 (range 18-71) and 55% were male. Of the 61 adult cases with notes available, 60 (98.3%) were of Asian ethnicity and 56 (92%) had a recent travel history, principally to the Indian Subcontinent. Symptoms included fever (100%), headache (62%), diarrhoea (59%) and abdominal pain (44%). Common examination findings included pyrexia and mild generalized abdominal tenderness. Mild hyponatraemia, transaminitis and a normal white cell count were commonly identified. Reduced ciprofloxacin sensitivity was common and increased over the study period. Median fever clearance time was 6 days, and treatment failure occurred in 20% of cases. Relapse occurred in 2 patients. Complications were unusual, and one patient died.
Patients with enteric fever presented with a non-specific febrile illness within one month after returning from travel, and most had an uncomplicated clinical course. Increasing ciprofloxacin insensitivity was the likely explanation for a high treatment failure rate and this agent can no longer recommended as empirical treatment.
肠热病在英国的归国旅行者中越来越常见。
我们对 1999 年 1 月至 2009 年 4 月期间在英国莱斯特大学医院住院的经培养确诊为肠热病的患者进行了回顾性描述性研究。
在成年人（n = 76）和儿童（n = 24）中发现了 100 例肠热病。成人患者的中位年龄为 38 岁（范围 18-71 岁），55%为男性。在有记录的 61 例成人病例中，60 例（98.3%）为亚洲人种，56 例（92%）有近期旅行史，主要前往印度次大陆。症状包括发热（100%）、头痛（62%）、腹泻（59%）和腹痛（44%）。常见的检查结果包括发热和轻度全身性腹部压痛。常见轻度低钠血症、转氨酶升高和白细胞计数正常。环丙沙星敏感性降低很常见，且在研究期间逐渐增加。中位退热时间为 6 天，20%的病例治疗失败。2 例患者复发。并发症不常见，1 例患者死亡。
肠热病患者在旅行后一个月内出现非特异性发热性疾病，大多数患者的临床过程不复杂。环丙沙星敏感性增加可能是治疗失败率高的原因，该药物不能再作为经验性治疗的推荐药物。
