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伤寒:诊断挑战与早期干预的重要性

Enteric Fever: Diagnostic Challenges and the Importance of Early Intervention.

作者信息

Saha Tias, Arisoyin Abimbola E, Bollu Bhaswanth, Ashok Tejaswini, Babu Athira, Issani Ali, Jhaveri Sharan, Avanthika Chaithanya

机构信息

Internal Medicine, Samorita General Hospital, Faridpur, BGD.

Internal Medicine, Diabetic Association Medical College, Faridpur, BGD.

出版信息

Cureus. 2023 Jul 13;15(7):e41831. doi: 10.7759/cureus.41831. eCollection 2023 Jul.

Abstract

Enteric fever is a systemic infection caused by highly virulent serovars: Typhi and Paratyphi. Diagnosis of enteric fever is challenging due to a wide variety of clinical features which overlap with other febrile illnesses. The current diagnostic methods are limited because of the suboptimal sensitivity of conventional tests like blood culture in detecting organisms and the invasive nature of bone marrow culture. It emphasizes the need to develop improved and more reliable diagnostic modalities. The rising rates of multidrug-resistant strains call for an accurate understanding of the current management of the disease. Proper public health measures and large-scale immunization programs will help reduce the burden of the disease. A comprehensive surveillance system can help detect the chronic carrier state and is crucial in understanding antibiotic susceptibility patterns. We conducted an all-language literature search on Medline, Cochrane, Embase, and Google Scholar till May 2022. The following search words and medical subject headings (MeSH) were used: "enteric fever," " Typhi," "multidrug-resistant ," chronic carrier state," " detection, "and "typhoid vaccine." We reviewed the literature on clinical features, pathophysiology, new diagnostic tests, and interventions to prevent the disease. This article explores enteric fever and its various clinical features and addresses the emerging threat of multidrug resistance. It focuses on novel methods for diagnosis and prevention strategies, including vaccines and the use of surveillance systems employed across different parts of the world.

摘要

伤寒热是由高毒力血清型

伤寒杆菌和副伤寒杆菌引起的全身性感染。由于多种临床特征与其他发热性疾病重叠,伤寒热的诊断具有挑战性。目前的诊断方法有限,因为血培养等传统检测方法在检测病原体方面的敏感性欠佳,且骨髓培养具有侵入性。这凸显了开发改进且更可靠的诊断方式的必要性。多重耐药菌株发生率的上升要求准确了解该疾病当前的治疗方法。适当的公共卫生措施和大规模免疫计划将有助于减轻疾病负担。全面的监测系统有助于检测慢性带菌状态,对于了解抗生素敏感性模式至关重要。我们在截至2022年5月的Medline、Cochrane、Embase和谷歌学术上进行了全语言文献检索。使用了以下检索词和医学主题词(MeSH):“伤寒热”、“伤寒杆菌”、“多重耐药”、“慢性带菌状态”、“检测”和“伤寒疫苗”。我们回顾了关于临床特征、病理生理学、新诊断测试以及预防该疾病干预措施的文献。本文探讨了伤寒热及其各种临床特征,并阐述了多重耐药这一新兴威胁。它重点关注诊断新方法和预防策略,包括疫苗以及世界各地使用的监测系统的应用。

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