Behera Jyoti Ranjan, Rup Amit R, Dash Arun K, Sahu Sanjay Kumar, Gaurav Abhinav, Gupta Abhas
Pediatrics, Kalinga Institute of Industrial Technology, Bhubaneswar, IND.
Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2021 Jan 20;13(1):e12826. doi: 10.7759/cureus.12826.
Enteric fever is a major health problem in developing countries. Varied clinical presentation leads to diagnostic dilemmas resulting in fatal complications.
To determine the socio-demographic, clinical manifestations, complications, antibiotic sensitivity pattern, treatment, and outcome in hospitalized enteric fever patients.
A retrospective case record analysis of hospitalized patients in the age group one to 14 years with a discharge diagnosis of enteric fever was done in a tertiary care centre of Odisha over a period of three years (January 2017 to December 2019).
Of 112 patients, 75% of children belonged to the six to 14 years age group with a mean age of 7.6 +/- 3.6 years and a male to female ratio of 1.66:1. The peak of cases was seen during the month of January to June with 94% of cases occurring in low and middle socioeconomic status. The commonest presentation was fever in 98.21%; other features were vomiting (39.29%), pain in abdomen (21.43%), diarrhoea (26.79%), and anorexia (14.29%). Eosinopenia was found in 58.93%, transaminitis in 30.36%, and raised CRP in 73.21%. In 30 children blood culture was positive with sensitivity to third-generation cephalosporin. All isolates were nalidixic acid-resistant Typhi (NARST). Complications were seen in 21.42%. All recovered and two left against medical advice.
Enteric fever is a major threat in the paediatric age group. Early clinical diagnosis with rational use of antibiotics according to sensitivity pattern is important. Improved hygiene, vaccination, and awareness among people is necessary for prevention.
伤寒热是发展中国家的一个主要健康问题。临床表现多样导致诊断困境，进而引发致命并发症。
确定住院伤寒热患者的社会人口统计学特征、临床表现、并发症、抗生素敏感性模式、治疗方法及预后。
在奥里萨邦的一家三级医疗中心，对三年期间（2017年1月至2019年12月）出院诊断为伤寒热的1至14岁住院患者进行回顾性病例记录分析。
112例患者中，75%的儿童年龄在6至14岁之间，平均年龄为7.6±3.6岁，男女比例为1.66:1。病例高峰出现在1月至6月，94%的病例发生在社会经济地位低和中等的人群中。最常见的表现是发热（98.21%）；其他特征包括呕吐（39.29%）、腹痛（21.43%）、腹泻（26.79%）和厌食（14.29%）。58.93%的患者出现嗜酸性粒细胞减少，30.36%的患者出现转氨酶升高，73.21%的患者CRP升高。30名儿童血培养呈阳性，对第三代头孢菌素敏感。所有分离株均为耐萘啶酸伤寒杆菌（NARST）。21.42%的患者出现并发症。所有患者均康复，2名患者不听从医嘱自行出院。
伤寒热对儿童年龄组是一个重大威胁。根据敏感性模式合理使用抗生素进行早期临床诊断很重要。改善卫生条件、接种疫苗以及提高人们的意识对于预防至关重要。
