Barrett Freja Cecille, Knudsen Jenny Dahl, Johansen Isik Somuncu
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark.
BMC Res Notes. 2013 Aug 11;6:315. doi: 10.1186/1756-0500-6-315.
Typhoid fever is a systemic illness which in high-income countries mainly affects travellers. The incidence is particularly high on the Indian subcontinent. Travellers who visit friends and relatives (VFR) have been shown to have a different risk profile than others. We wished to identify main characteristics for travellers infected with S. Typhi considering both clinical and laboratory findings in order to provide for faster and better diagnostics in the future. The outcome of treatment, especially concerning relapse, was evaluated as well.
Retrospectively collected data from 19 adult cases of typhoid fever over a 5-year period at the Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Denmark.
The patients were young adults, presenting with symptoms within a month after travelling. 84% were returned from travelling in the Indian subcontinent. 17 out of 19 patients were VFR-travellers. The main symptoms were fever (100%), gastrointestinal symptoms (84%), headache (58%) and dry cough (26%). Laboratory findings showed elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH) in all cases and elevated alanine transaminase (ALAT) in 47% of cases. In primary cases 4 isolates were fully susceptible to ciprofloxacin, the remaining were intermediate susceptible. Relapse occurred in 37% of the cases and only in cases where the patient was infected by a strain with intermediate susceptibility.
Better pre-travel counselling should be given to VFR-travellers. The main symptoms and laboratory findings confirm previous findings. The relapse rate was unexpected high and could be correlated to ciprofloxacin-resistance.
伤寒热是一种全身性疾病，在高收入国家主要影响旅行者。印度次大陆的发病率尤其高。有研究表明，探亲访友的旅行者（VFR）与其他旅行者的风险状况不同。我们希望通过综合临床和实验室检查结果，确定感染伤寒杆菌的旅行者的主要特征，以便未来能实现更快、更准确的诊断。同时，我们也评估了治疗结果，尤其是复发情况。
回顾性收集丹麦哥本哈根大学医院Hvidovre分院传染病科5年内19例成人伤寒热病例的数据。
患者均为年轻人，旅行后一个月内出现症状。84%的患者从印度次大陆旅行归来。19名患者中有17名是探亲访友的旅行者。主要症状包括发热（100%）、胃肠道症状（84%）、头痛（58%）和干咳（26%）。实验室检查结果显示，所有病例的C反应蛋白（CRP）和乳酸脱氢酶（LDH）均升高，47%的病例谷丙转氨酶（ALAT）升高。在初发病例中，4株分离菌对环丙沙星完全敏感，其余为中度敏感。37%的病例出现复发，且仅发生在患者感染中度敏感菌株的情况下。
应向探亲访友的旅行者提供更好的旅行前咨询。主要症状和实验室检查结果证实了先前的研究发现。复发率出乎意料地高，可能与环丙沙星耐药性有关。
