Bakeer Mohammed Saied, Youssef Mohamed Ibrahim, Elshazly Helmy M, Abdel-Samiee Mohamed, El-Gendy Abdelaleem A, Abouzed M, Othman Warda, Abdelkareem Mervat, Abozeid Mai, Awad Samah Mohammed, Khalil Fatma O, Bedair Hanan M, Diab Karema A, Seif A S, Youssef Marwa F, Sakr Ayman Ahmed, Abdelsameea Eman
Internal Medicine Department, Al-Azhar University, Cairo, Egypt.
Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Menoufia, Egypt.
Infect Drug Resist. 2019 Aug 22;12:2573-2582. doi: 10.2147/IDR.S206642. eCollection 2019.
As physicians in a referral hospital, we observed the association between history of enteric fever and somatic disorders associated with low mood. At the Al-Hussein University Hospital, Cairo and the National Liver Institute Hospital, Menoufia, we receive patients from all over Egypt, including rural areas where enteric fever is endemic.
Here in, 60 Egyptian patients referred to us for evaluation of different somatic disorders are reported.
After extensive evaluations, the patients' symptoms were function-related. Also, their typhoid carrier states were documented, and the severity of depression using Hamilton-D (HAM-D) questionnaire was evaluated and recorded. All patients were treated with ceftriaxone, 2 gm, IV, daily for 15 days. The clinical evaluation and Hamilton score were reassessed at the end of the treatment and 6 weeks thereafter. The patients did not receive any anti-depressant nor anti-anxiety treatment during their course. Typhoid carrier was defined by documenting the history of typhoid fever that was diagnosed by culturing the species, and not by serology, isolated from stool culture along with febrile condition, plus the absence of fever in the past 3 weeks. The Widal test was not accepted as a criterion for enrollment.
Patients showed clinically significant improvement in the somatic complaints, and their HAM-D score immediately post-treatment that was consolidated for 6 weeks post-treatment completion.
In this study, the typhoid carrier was associated with the psychosomatic depression that improved by antibiotic therapy.
作为一家转诊医院的医生，我们观察到肠热病病史与情绪低落相关的躯体疾病之间的关联。在开罗的侯赛因大学医院和米努夫省的国家肝脏研究所医院，我们接收来自埃及各地的患者，包括肠热病流行的农村地区。
本文报告了60例因各种躯体疾病转诊至我院进行评估的埃及患者。
经过广泛评估，患者的症状与功能相关。此外，记录了他们的伤寒带菌状态，并使用汉密尔顿抑郁量表（HAM-D）评估并记录了抑郁的严重程度。所有患者均接受头孢曲松治疗，静脉注射2克，每日1次，共15天。在治疗结束时及此后6周重新评估临床评估和汉密尔顿评分。患者在病程中未接受任何抗抑郁或抗焦虑治疗。伤寒带菌者的定义为记录经粪便培养分离出的菌种确诊的伤寒热病史（而非通过血清学），伴有发热状况，且过去3周无发热。维达试验不作为入组标准。
患者的躯体主诉在临床上有显著改善，其HAM-D评分在治疗后立即改善，并在治疗完成后6周保持稳定。
在本研究中，伤寒带菌者与心身性抑郁有关，抗生素治疗可改善这种抑郁。
