Current clinical patterns of typhoid fever: a prospective study.

This paper reports on a prospective study comprising 125 consecutive adult cases of typhoid fever diagnosed on the basis of positive cultures for typhoid organisms. Salmonella typhi infection was found to be more frequent (89.6%) than S. paratyphi A & B (10.4%). Onset of the disease was usually insidious and the classical step-ladder pattern of fever was uncommon (12%). Rose spots were observed in 9.6% cases. Gut perforation was more common, while typhoid toxaemia and peripheral circulatory failure were less frequent than in most of the series reported from India. Both these variations are ascribed to the widespread use of corticosteroids in our patients. Gut perforation alone accounted for three-quarters of the deaths.