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伤寒热:病例报告与文献综述。

Typhoid fever: case report and literature review.

作者信息

Sanhueza Palma Natalia Carolina, Farías Molina Solange, Calzadilla Riveras Jeannette, Hermoso Amalia

机构信息

Hospital San Juan de Dios, Curicó, Región del Maule, Chile. Address: Pasaje Los Vilos 7, Población La Marquesa, Curicó, Región del Maule, Chile. Email:

Hospital San Juan de Dios, Curicó, Región del Maule, Chile.

出版信息

Medwave. 2016 Jun 21;16(5):e6474. doi: 10.5867/medwave.2016.05.6474.

Abstract

Typhoid fever remains a major health problem worldwide, in contrast to Chile, where this disease is an isolated finding. Clinical presentation is varied, mainly presenting with fever, malaise, abdominal discomfort, and nonspecific symptoms often confused with other causes of febrile syndrome. We report a six-year-old, male patient presenting with fever of two weeks associated with gastrointestinal symptoms, malaise, hepatomegaly and elevated liver enzymes. Differential diagnoses were considered and a Widal reaction and two blood cultures were requested; both came back positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Prior to diagnosis confirmation, empirical treatment was initiated with ceftriaxone and metronidazole, with partial response; then drug therapy was adjusted according to ciprofloxacin susceptibility testing with a favorable clinical response. We discuss diagnostic methods and treatment of enteric fever with special emphasis on typhoid fever.

摘要

伤寒热仍是全球主要的健康问题,而在智利,这种疾病只是个别病例。临床表现多样,主要表现为发热、不适、腹部不适以及常与其他发热综合征病因相混淆的非特异性症状。我们报告一名6岁男性患者,发热两周并伴有胃肠道症状、不适、肝肿大和肝酶升高。考虑了鉴别诊断,并进行了肥达反应和两次血培养;结果均呈阳性,确诊为伤寒杆菌引起的伤寒热。在确诊之前,开始使用头孢曲松和甲硝唑进行经验性治疗,有部分疗效;然后根据环丙沙星药敏试验调整药物治疗,临床反应良好。我们讨论了肠热病的诊断方法和治疗,特别强调了伤寒热。

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