Kumar Praveen, Kumar Ruchika
Department of Pediatrics, Lady Hardinge Medical College & Associated Kalawati Saran Children's Hospital, New Delhi, 110001, India.
Indian J Pediatr. 2017 Mar;84(3):227-230. doi: 10.1007/s12098-016-2246-4. Epub 2016 Oct 29.
Enteric fever is an important public-health problem in India. The clinical presentation of typhoid fever is very variable, ranging from fever with little other morbidities to marked toxemia and associated multisystem complications. Fever is present in majority of patients (>90 %) irrespective of their age group. Mortality is higher in younger children. Blood culture remains gold standard for diagnosis. Widal test has low sensitivity and specificity but may be used in second week to support the diagnosis. Emerging resistance to several antibiotics should be kept in mind when selecting antibiotics or revising the treatment. The key preventive strategies are safe water, safe food, personal hygiene, and appropriate sanitation. Vaccination is an additional effective tool for prevention.
肠热症在印度是一个重要的公共卫生问题。伤寒热的临床表现差异很大,从仅有低热而无其他明显病症到严重毒血症及相关多系统并发症不等。无论年龄组如何,大多数患者(>90%)都会发热。年幼儿童的死亡率更高。血培养仍是诊断的金标准。肥达试验的敏感性和特异性较低,但可在第二周用于辅助诊断。在选择抗生素或调整治疗方案时,应考虑到对多种抗生素出现的耐药性问题。关键的预防策略包括安全的饮用水、安全的食品、个人卫生和适当的环境卫生。疫苗接种是预防的另一有效手段。