Margaret A Priya, Solomon P John, Lohith Harita
Department of Paediatrics, Sree Balaji Medical College, Chrompet, Chennai, Tamil Nadu, India.
J Pharm Bioallied Sci. 2015 Apr;7(Suppl 1):S65-6. doi: 10.4103/0975-7406.155806.
A rare case of typhoid presenting with thrombocytopenia, hyponatremia, ascites mesenteric adenitis, and multi-drug resistance is being presented in this article. An 8-year-old girl was admitted with a history of fever, vomiting, abdominal pain and loose stools. Clinical examination revealed fever and hepatosplenomegaly. Investigations showed leucopenia, thrombocytopenia and hyponatremia. Blood Widal was positive, and blood culture grew Salmonella typhi. Ultrasound abdomen revealed ascites, hepatosplenomegaly, mesenteric lymphadenopathy and thickening of the gall bladder. She was treated with ciprofloxacin intravenously for 6 days and when the fever persisted injection ceftriaxone was added. Ciprofloxacin was given intravenously for a total of 15 days and injection ceftriaxone was given for 12 days. Even then, the fever persisted and hence oral azithromycin was added. Fever subsided completely in 3 days with azithromycin and she became asymptomatic without fever, loose stools, abdominal pain or anything on follow-up after 3 months.
本文报告了一例罕见的伤寒病例，该病例伴有血小板减少、低钠血症、腹水、肠系膜腺炎和多重耐药。一名8岁女孩因发热、呕吐、腹痛和腹泻病史入院。临床检查发现发热和肝脾肿大。检查显示白细胞减少、血小板减少和低钠血症。肥达氏反应阳性，血培养生长出伤寒杆菌。腹部超声显示腹水、肝脾肿大、肠系膜淋巴结病和胆囊增厚。她接受了6天的静脉注射环丙沙星治疗，当发热持续时加用了头孢曲松注射液。环丙沙星静脉注射共15天，头孢曲松注射液注射12天。即便如此，发热仍持续，因此加用了口服阿奇霉素。使用阿奇霉素后3天发热完全消退，3个月后随访时她无症状，无发热、腹泻、腹痛或其他任何症状。
